title: Cephalometric pattern and nasal patency in children with primary snoring: the evidence of a direct correlation.
abstract: BACKGROUND
  Sleep disordered breathing (SDB) might affect craniofacial growth and children with obstructive sleep apnea syndrome present an increase in total and lower anterior heights of the face and a more anterior and inferior position of the hyoid bone when compared to nasal breathers.
  
  
  OBJECTIVE
  To investigate the correlation between rhinomanometric and cephalometric parameters in children with primary snoring (PS), without apnea or gas exchange abnormalities.
  
  
  METHODS
  Thirty children with habitual snoring (16 females and 14 males) aged 4-8 years (mean age 6.85±1.51 years) were selected by a SDB validate questionnaire. All subjects underwent lateral cephalometric, panoramic radiographies.
  
  
  RESULTS
  In our sample 10 children (33%) had snoring 3 nights/week, 11 (37%) 4-6 nights/week and 9 (30%) every night/week. Overall 7 patients (23.3%) were affected by adenoid hypertrophy (AH), 4 (13.3%) by tonsillar hypertrophy (TH) and 13 (43.3%) by AH and TH. We found a more vertical position of the hyoid bone to the mandibular plane (H⊥VT) in patients with a higher frequency (7.3±2.7 vs 7.6±3.7 vs 10.9±2.5 in children snoring 3 nights/week, 4-6 nights/week and every night/week respectively; p = 0.032). Concerning nasal patency significant correlations were found with ANB (maxillary and jaw position with respect to the cranial base), NS∧Ar (growth predictor), sumangle, FMA (total divergence), SnaSnp∧GoMe (inferior divergence), BaN∧PtGn (facial growth pattern), Phw1_PsP (posterosuperior airway space), AHC3H (the horizontal distance between the most anterosuperior point of the hyoid bone and the third cervical vertebra).
  
  
  CONCLUSIONS
  The present study supports the relationship between nasal obstruction and specific craniofacial characteristics in children with primary snoring and lead us to hypothesize that nasal obstruction might explain the indirect link between snoring and cephalometric alterations.
authors.affiliation: Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Zicari
authors.affiliation: Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Duse
authors.affiliation: Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Occasi
authors.affiliation: Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Luzzi
authors.affiliation: George Eastman "Odontoiatric hospital", Rome, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Ortolani
authors.affiliation: Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Flaminia
authors.initials: F
authors.lastname: Bardanzellu
authors.affiliation: Department of pediatric otorhinolaryngology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Bertin
authors.affiliation: Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Polimeni
mesh_terms: D002508:Cephalometry; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009666:Nose / Q000503:physiopathology*; D012913:Snoring / Q000503:physiopathology*