Objectives: The aim of this study was to evaluate the effectiveness of three different methods of treatment for the enlargement of the rhinopharynx space and an improvement of the intermaxillary relations in patients with adenotonsillar hypertrophy. Material and methods: A total of 12 patients (8 male, 4 females; mean age 6.5 years range 4-12 years) were enrolled for this study. The inclusion criteria were: a) moderately severe or severe adenotonsillar hypertrophy with adenoids occupying 70% or more of the nasopharyngeal airway; b) pathologies associated to adenotonsillar hypertrophy such as: sleep apnea, rhinosinusitis, otitis, hypoacusia, dislalie; c) presence of oromaxillo-facial anomalies such as: ogival palate, malocclusion, anterior open bite. The 12 patients were randomly assigned in four groups of three patients. Group A: patients treated with rapid palatal expansion, Group B: patients treated with adenectomy, Group C: patients that had received pharmacological treatment and Group D: control group, no treatment. To evaluate the enlargement of the rhinopharynx space were used an anterior rhinoscopy and lateral cephalometric radiographs according to the cephalometric analysis proposed by Giannì. Intermaxillary relations were evaluated with lateral cephalometric radiographs according to the cephalometric analysis proposed by Steiner. All the analysis were executed before (T0) and eight months (T1) after the various treatments. Results: The anterior rhinoscopy has showed a reduction of the adenoid volume in the Groups A, B and C. In the patients that had not received any treatment the volume of the adenoids remained stable or increased. The results of the anterior rhinoscopy were confirmed by the cephalometric analysis for the enlargement of the rhinopharynx space proposed by Giannì even though statistically significant differences were only detected between Group A and Group D (p<0.05 Mann-Whitney test). Regarding the intermaxillary relation an improvement was detected in all four groups even though there were no statistically significant differences. Discussion: Adenotonsillar hypertrophy particularly in the early age can cause an incomplete facial growth, therefore, the cephalometric analysis of the intermaxillary relation can be used by the clinician as a diagnostic method for the therapeutical choice in this type of pathology. All three methods are effective regarding the treatment of the symptoms in patients with adenotonsillar hypertfophy. Furthermore, independently the type of treatment an increase rhinopharynx space was detected. However, nowadays with the use of cone-beam computed tomography the pharyngeal airway volumes can be easily measured.

Cephalometric variation of the rhinopharynx space and intermaxillary relations in pedodontic patients with adenotonsillar hypertrophy

TRIPODI, Domenico;D'ERCOLE, Simonetta;D'ATTILIO, Michele
2010-01-01

Abstract

Objectives: The aim of this study was to evaluate the effectiveness of three different methods of treatment for the enlargement of the rhinopharynx space and an improvement of the intermaxillary relations in patients with adenotonsillar hypertrophy. Material and methods: A total of 12 patients (8 male, 4 females; mean age 6.5 years range 4-12 years) were enrolled for this study. The inclusion criteria were: a) moderately severe or severe adenotonsillar hypertrophy with adenoids occupying 70% or more of the nasopharyngeal airway; b) pathologies associated to adenotonsillar hypertrophy such as: sleep apnea, rhinosinusitis, otitis, hypoacusia, dislalie; c) presence of oromaxillo-facial anomalies such as: ogival palate, malocclusion, anterior open bite. The 12 patients were randomly assigned in four groups of three patients. Group A: patients treated with rapid palatal expansion, Group B: patients treated with adenectomy, Group C: patients that had received pharmacological treatment and Group D: control group, no treatment. To evaluate the enlargement of the rhinopharynx space were used an anterior rhinoscopy and lateral cephalometric radiographs according to the cephalometric analysis proposed by Giannì. Intermaxillary relations were evaluated with lateral cephalometric radiographs according to the cephalometric analysis proposed by Steiner. All the analysis were executed before (T0) and eight months (T1) after the various treatments. Results: The anterior rhinoscopy has showed a reduction of the adenoid volume in the Groups A, B and C. In the patients that had not received any treatment the volume of the adenoids remained stable or increased. The results of the anterior rhinoscopy were confirmed by the cephalometric analysis for the enlargement of the rhinopharynx space proposed by Giannì even though statistically significant differences were only detected between Group A and Group D (p<0.05 Mann-Whitney test). Regarding the intermaxillary relation an improvement was detected in all four groups even though there were no statistically significant differences. Discussion: Adenotonsillar hypertrophy particularly in the early age can cause an incomplete facial growth, therefore, the cephalometric analysis of the intermaxillary relation can be used by the clinician as a diagnostic method for the therapeutical choice in this type of pathology. All three methods are effective regarding the treatment of the symptoms in patients with adenotonsillar hypertfophy. Furthermore, independently the type of treatment an increase rhinopharynx space was detected. However, nowadays with the use of cone-beam computed tomography the pharyngeal airway volumes can be easily measured.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11564/270282
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