Meta-analysis: effects of adenoidectomy/tonsillectomy on pediatric maxillary growth development

Quantitative analysis of adenoid size plays a pivotal role in experimental research, and imaging examinations are extensively employed for this purpose. This study aims to investigate the impact of adenoidectomy/tonsillectomy on the maxillary growth and respiratory outcomes of children. A comprehensive systematic search was conducted across multiple databases, including PubMed, Web of Science and Scopus, utilizing the following keywords: "gland resection", "tonsillectomy", "mouth breathing", "airway obstruction", "low ventilation", "obstructive sleep apnea (OSA) syndrome" and "dental maxillary growth" in articles published between January 2000 and April 2022. The eligibility criteria encompassed studies with a well-defined research question, appropriate sample size and reporting of pertinent cephalometric indices. The risk of bias was assessed using the Cochrane Risk of Bias tool. Heterogeneity between studies was evaluated using the Q test and I² statistics. Based on the meta-analysis of six studies, the odds ratio (OR) values for the influence of adenoidectomy/tonsillectomy on nasal line-nasion-sella line (NL-NSL) and mandibular line-nasion-sella line (ML-NSL) in children's maxillary growth were -0.84 and 0.58, respectively, with 95% confidence intervals (CI) of (-1.08, -0.61) and (0.34, 0.81). No heterogeneity was observed between studies (I² = 0.00% for both). In five studies, the OR values for the influence of adenoidectomy/tonsillectomy on children's maxillary growth angle formed by the sella-nasion line and line N-point A (SNA), and angle formed by the sella-nasion line and line N-point B (SNB) were -0.30 and -0.31, respectively, with 95% CI of (-0.55, -0.06) and (-0.56, -0.07). No heterogeneity was observed among studies (I² = 0.00% for both). The study indicated that adenoidectomy/tonsillectomy has a positive impact on the maxillary growth and respiratory issues in children.