[Pre-orthognathic surgery in orthodontics: towards justification]

Area of Science:

• Otolaryngology
• Pediatric Airway Management
• Orthodontics

Context:

• Rhinopharyngeal obstruction significantly impacts pediatric airway function and oral ventilation.
• Enlarged tonsils and adenoids can displace the tongue, affecting breathing patterns in children.
• Existing surgical techniques for rhinopharyngeal desobstruction vary in efficacy.

Purpose:

• To evaluate the long-term efficacy of various rhinopharyngeal desobstruction techniques in 9-year-old patients.
• To assess the impact of rhinopharyngeal obstruction on tongue behavior and upper airway ventilation.
• To introduce a comprehensive ENT approach, the "Chimney Sweep" procedure, for managing pediatric airway issues.

Summary:

• The study assessed long-term outcomes of rhinopharyngeal desobstruction in children using techniques like tonsillectomy, adenoïdectomy, and turbinectomy.
• The "Chimney Sweep" procedure, a combination of adenotonsillectomy and endoscopic inferior turbinectomy, demonstrated superior efficacy in improving nasal and oral airflow.
• Rhinopharyngeal obstruction negatively affects tongue posture and function, necessitating potential lingual interventions (glossoplasty or glossectomy) for optimal morphogenic development.

Impact:

• The "Chimney Sweep" procedure offers an effective solution for pediatric rhinopharyngeal obstruction, enhancing airway patency.
• Addressing tongue dysfunction alongside airway surgery is crucial for proper craniofacial growth and development.
• This integrated ENT and pre-orthognathic approach provides a framework for managing complex pediatric airway and orthodontic challenges.