Effect of mouth breathing etiologies on craniofacial morphology

ntroduction: Nasal septal deviation and hypertrophy of the adenoids and palatine tonsils are the two common causes of nasopharyngeal obstruction and resulting mouth breathing in children. It is accepted that chronic mouth breathing influences craniofacial growth and development. The aim of this study was to evaluate the differences of craniofacial morphology in children with two different etiological factors of mouth breathing. In this cross sectional study we studied 47 patients aged 6-10 years with predominant mouth breathing during 2005-2007. After otorhinolaryngologic examination, patients were divided into two groups based on the etiology of nasopharyngeal obstruction: group 1 with adenoid hypertrophy and group 2 with nasal septal deviation. Lateral cephalometric radiographs were obtained to assess craniofacial development. For statistical analysis Mann-Whitney and T-student tests were used. With respect to the inclination of the mandibular and palatal planes, anteroposterior relationship of maxilla and mandible to the cranial base, and indexes of facial height proportions, no significant difference was observed between two groups of children with mouth breathing. Only the gonial and craniocervical angle measurements were significantly larger in children with adenoid hypertrophy (P<0.05). The present study did not show any significant morphological differences between children with adenoid hypertrophy and those with nasal septal deviation. Mouth breathing seems to have a similar effect on craniofacial morphology irrespective of its etiology. Prospective studies with larger samples including older children are suggested.