title: The effect of adenoid hypertrophy on maxillofacial development: an objective photographic analysis.
abstract: BACKGROUND
  Deformity in the dental arc and facial skeleton by adenoid hypertrophy due to chronic mouth breathing is a well-known process. Most of the related studies have been based on cephalometric analyses. The aim of this study is to detect the presence of skeletal deformities on the soft tissue by analyzing distances and angles on photographs.
  
  
  METHODS
  Ninety-seven children having between 25 and 100 % of adenoids, ages 4-12 years (48 boys, 49 girls), and 90 cases having 0-25 % adenoid tissue, ages 4-12 years (54 boys, 36 girls), were studied by clinical history, physical examination (including endoscopy), and standardized clinical photographs. The children and parents were asked if any of the following were present in the children: snoring, sleep apnea, daytime sleepiness, poor school performance, mouth breathing during sleep, smoking parents, and restlessness during sleep.
  
  
  RESULTS
  The assessment of linear and angular measurements on the clinical photographs showed, in the group having thicker adenoids compared with controls, a statistically significant increase in the distance between nasion and tip and nasion and subnasale and in the angle between Frankfort horizontal plane-gnathion-angulus mandible; there was also a statistically significant decrease in the distance between endocanthion and exocanthion and the angles between tragion-angulus mandible and gnathion and between nasion-angulus mandible and gnathion.
  
  
  CONCLUSIONS
  The analyses showed a significant increase in the anterior face height and increase in the angle between Frankfort horizontal plane-gnathion-angulus mandible and a retropositioned and posterior-rotated mandible due to thicker adenoids.
  
  
  BACKGROUND
  2010/140 Date: 04 January 2010.
authors.affiliation: Otorhinolaryngology (KBB) Department, Malatya State Hospital, Malatya, Turkey. cifirat@hotmail.com.
authors.forename: Cigdem Fırat
authors.initials: CF
authors.lastname: Koca
authors.affiliation: Medical Faculty, Otorhinolaryngology (KBB) Department, Acıbadem University, Istanbul, Turkey.
authors.forename: Tamer
authors.initials: T
authors.lastname: Erdem
authors.affiliation: Medical Faculty, Otorhinolaryngology (KBB) Department, Inonu University, Malatya, Turkey.
authors.forename: Tuba
authors.initials: T
authors.lastname: Bayındır
mesh_terms: D000234:Adenoids / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005145:Face / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008334:Mandible / Q000033:anatomy & histology*; D008445:Maxillofacial Development; D010781:Photography
keywords: Adenoid hypertrophy; Facial morphology; Mouth breathing; Photographic analysis