The effect of adenoid hypertrophy duration on craniofacial development.

Objective: Duration of disease plays an important role in the relationship of adenoid hypertrophy and craniofacial morphology. This study aimed to analyse the association of adenoid hypertrophy with craniofacial features in different duration groups.

Methods: Cephalograms were obtained from 216 participants aged 3-14 years. The effects of varying durations of snoring and oral breathing, as well as the risk of OSA, on craniofacial development were compared. Associations between craniofacial development and relevant clinical factors were evaluated using logistic regression analysis.

Results: Compared with the Ad/Np ≤ 0.7 group, children in the Ad/Np > 0.7 group had significantly reduced SNA and SNB angles, increased nose length, and alterations in vertical and soft tissue parameters (all p < 0.05). Snoring >1 year correlated with decreased lip protrusion angle and increased mandibular angle/facial width (p < 0.05). Oral breathing >3 months in Ad/Np > 0.7 children reduced ANB angle (p = 0.02) but increased upper lip thickness (D-C, p = 0.038). Multivariate regression analysis identified that the Ad/Np ratio was associated with changes in SNA and SNB. Snoring duration and oral breathing were determined as influencing factors for dentofacial protrusion and alterations in upper lip soft tissue morphology.

Conclusion: Children with adenoid hypertrophy are independently associated with sagittal skeletal discrepancies and show altered craniofacial growth patterns. Prolonged snoring (>1 year) and oral breathing (>3 months) exacerbate dentofacial protrusion and upper lip (soft tissue) morphological changes.