Department of Orthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, P.R. China.
BMC Pediatr. 2023 Apr 6;23(1):163. doi: 10.1186/s12887-023-03979-2.
When analyzing the relationship between adenotonsillar hypertrophy and craniofacial morphology, researchers generally regarded hypertrophied adenoids and tonsils as a whole. It remains unclear whether different enlarged sites of pharyngeal lymphoid tissue would correlate with multiple craniofacial subtypes. We hypothesized there would be craniofacial subtypes correlated with different locations of hypertrophied adenoid and tonsil.
Lateral cephalometric radiographs were obtained from 466 children (171 boys and 295 girls, aged 12.27 ± 2.69 years). They were divided into four groups according to different sites of enlarged pharyngeal lymphoid tissue: adenoid hypertrophy group (AG, n = 126), tonsillar hypertrophy group (TG, n = 59), adenotonsillar hypertrophy group (ATG, n = 69) and control group (CG, n = 212). Five commonly used angles for cephalometric measurements were investigated: SNA (Sella-Nasion-Point A), SNB (Sella-Nasion-Point B), ANB (Point A-Nasion-Point B), mandibular plane angle (MP/SN) and Y-axis angle (SGn/FH).
Children with isolated tonsillar hypertrophy correlated with increased SNA (unstandardized regression coefficient B = 1.38, p = 0.009) and SNB (B = 1.99, p = 0.001) compared with controls. However, children with isolated adenoid hypertrophy correlated with decreased SNB (B=-0.94, p = 0.036), increased ANB (B = 0.74, p = 0.014) and increased MP/SN (B = 2.22, p < 0.001). Similarly, children with adenotonsillar hypertrophy correlated with decreased SNB (B=-1.36, p = 0.015), increased ANB (B = 1.35, p < 0.001) and increased MP/SN (B = 2.64, p = 0.001).
Isolated adenoid hypertrophy correlated with a retrognathic mandible, an increased maxillo-mandibular sagittal discrepancy, and an increased mandibular plane angle. Isolated tonsillar hypertrophy correlated with maxillary and mandibular protrusion. Adenotonsillar hypertrophy did not show a superimposed craniofacial pattern of the above two but showed the same craniofacial pattern as isolated adenoid hypertrophy.
在分析腺样体和扁桃体肥大与颅面形态的关系时，研究人员通常将肥大的腺样体和扁桃体视为一个整体。然而，咽淋巴组织不同部位的肿大是否与多种颅面亚型相关，目前尚不清楚。我们假设不同部位的腺样体和扁桃体肥大与多种颅面亚型相关。
收集 466 名儿童（男 171 名，女 295 名，年龄 12.27±2.69 岁）的侧位头颅侧位片。根据咽淋巴组织不同部位的肿大，将其分为 4 组：腺样体肥大组（AG 组，n=126）、扁桃体肥大组（TG 组，n=59）、腺样体扁桃体肥大组（ATG 组，n=69）和对照组（CG 组，n=212）。分析了 5 种常用的头影测量角度：SNA（蝶鞍-鼻根点-上齿槽点）、SNB（蝶鞍-鼻根点-下齿槽点）、ANB（上齿槽点-鼻根点-下齿槽点）、下颌平面角（MP/SN）和 Y 轴角（SGn/FH）。
与对照组相比，单纯性扁桃体肥大组的儿童 SNA（未标准化回归系数 B=1.38，p=0.009）和 SNB（B=1.99，p=0.001）增加；单纯性腺样体肥大组儿童 SNB 减少（B=-0.94，p=0.036），ANB 增加（B=0.74，p=0.014），MP/SN 增加（B=2.22，p<0.001）；腺样体扁桃体肥大组儿童 SNB 减少（B=-1.36，p=0.015），ANB 增加（B=1.35，p<0.001），MP/SN 增加（B=2.64，p=0.001）。
单纯性腺样体肥大与下颌后缩、上下颌矢状骨不调增加和下颌平面角增大有关。单纯性扁桃体肥大与上颌和下颌前突有关。腺样体扁桃体肥大并没有表现出上述两种类型的叠加颅面模式，而是表现出与单纯性腺样体肥大相同的颅面模式。
