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Published on: May 6, 2014
The hyoid bone position and upper airway morphology among children with and without adenotonsillar hypertrophy: a
Yaqi Li1,2, Susu Yi1,2, Jun Zhang3
1State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
Insights
Children with enlarged tonsils (tonsillar hypertrophy only) had a more inferior hyoid bone position and wider airway space. Enlarged adenoids (adenoid hypertrophy only) were linked to a longer soft palate in pediatric obstructive sleep apnea patients.
Area of Science:
- Pediatric Dentistry
- Orthodontics
- Sleep Medicine
- Otolaryngology
Background:
- Adenotonsillar hypertrophy (ATH) is a primary cause of pediatric obstructive sleep apnea (OSA).
- The impact of ATH on craniofacial development, including hyoid bone position and upper airway morphology, requires further investigation.
Purpose of the Study:
- To compare hyoid bone position and upper airway morphology in children with and without ATH.
- To investigate differences in craniofacial structures associated with isolated adenoid hypertrophy versus isolated tonsillar hypertrophy.
Main Methods:
- 199 children (aged 6-8 years) underwent pre-treatment lateral cephalography.
- Adenoid and tonsil sizes were classified using Fujioka's and Baroni's methods.
- Hyoid bone position and upper airway morphology were analyzed using Dolphin Imaging Software.
Main Results:
- The tonsillar hypertrophy only (THO) group showed a greater distance between the hyoid bone and mentum compared to the adenoid hypertrophy only (AHO) group.
- The AHO group had a longer soft palate (SPL) than the THO group, while the THO group had a reduced SPL compared to controls.
- The THO group exhibited a more inferior tongue position and significantly wider inferior airway space than healthy children.
Conclusions:
- ATH is associated with distinct hyoid bone positions and upper airway morphologies in children.
- Enlarged tonsils correlate with a more inferior hyoid bone position, while enlarged adenoids correlate with a longer soft palate.
- Findings suggest potential orthodontic implications for children with ATH and altered airway dimensions.
Background:
Adenotonsillar hypertrophy (ATH) is a major cause of pediatric obstructive sleep apnea (OSA), potentially impacting craniofacial growth and development. Currently, whether children with ATH exhibit distinctive hyoid bone position and upper airway morphology remains uncertain. This research aimed to compare the hyoid bone position and upper airway morphology of children with and without ATH.
Methods:
A total of 199 children aged 6-8 years were recruited for the study, and their pre-treatment lateral cephalograms were obtained. The size of the adenoids and tonsils on the lateral cephalogram was assessed based on Fujioka's and Baroni's methods for classification into groups: adenoid hypertrophy only (AHO) group, tonsillar hypertrophy only (THO) group, adenoid and tonsillar hypertrophy (AH + TH) group, and control group (CG). The position of the hyoid bone and upper airway morphology was analyzed using Dolphin Image Software.
Results:
The distance between the hyoid bone and mentum was greater in the THO group compared to the AHO group (P = 0.005). Children in the AHO group exhibited a longer soft palate (SPL) compared to the THO group (P = 0.014), whereas the THO group displayed a reduced SPL in comparison to healthy controls (P = 0.008). The THO group showed a more inferior tongue position compared to children in the AHO group (P = 0.004). Subjects in the THO group exhibited significantly wider inferior airway space compared to healthy children (P < 0.001).
Conclusions:
Adenotonsillar hypertrophy may be associated with hyoid bone position and upper airway morphology in children seeking for orthodontic treatment. In children with enlarged tonsils, the hyoid bone was positioned farther from the mentum than in those with enlarged adenoids. Conversely, children with enlarged adenoids had a longer soft palate compared to those with enlarged tonsils.
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