Anatomical Basis of Sleep-Related Breathing Abnormalities in Children With Nasal Obstruction

Abstract

A number of anatomical abnormalities may contribute to sleep-related abnormal breathing in otherwise normal children with nasal obstruction. Our results suggest that symptomatic children show some of the same skeletal and soft-tissue configurations that are found in adults with obstructive sleep apnea. While adenoidectomy is generally an effective treatment in children with obstructive sleep-related breathing abnormalities, the underlying craniofacial variances that remain after adenoidectomy may predispose these patients to redevelopment of obstructive breathing abnormalities in adulthood.

The correlation between craniofacial morphology and sleep-disordered breathing in children in an undergraduate orthodontic clinic

“…However, there were many significant correlations between SDB symptoms and craniofacial-related variables (Tables 4 and 5). Interestingly, many of these craniofacial characteristics are similar to what has been reported previously as being correlated with SDB or snoring symptoms [7,17,[20][21][22][23][24][25]. The etiology of SDB is believed to involve multiple factors, and our results suggest that factors such as nasal obstruction and mouth breathing, for example, may affect morphology even if subjects exhibit good overall health.…”

Atualização em síndrome da apnéia obstrutiva do sono na infância

“…Therefore, any malformation such as choanal atresia, micrognathia, mandibular hypoplasia and other skull base abnormalities (e.g. platibasia) may cause respiratory obstruction 10 . Micrognathia is reported in more than 60 genetic syndromes (hemifacial microssomia, Treacher-Collins, Goldenhar, Pierre Robin, etc.)…”

“…Bone abnormalities of rhinopharynx limits may decrease its antero-posterior diameter. Possibly it is the cause why not all children with adenoid hypertrophy have respiratory disorders while sleeping, however, some other children continue snoring even after adenoidectomy 10 . Genioglossal bone promotes tongue protrusion preventing it from moving towards the posterior wall of the oropharynx under normal conditions.…”

“…Genioglossal bone promotes tongue protrusion preventing it from moving towards the posterior wall of the oropharynx under normal conditions. Mouth breathing habit results in dorso-caudal rotation of mandible changing the position of the genioglossal muscle by decreasing tongue protrusion 10 . Abnormal dorsal-caudal positioning of the hyoid bone in some children is the cause of respiratory disorder while sleeping.…”

Orthodontic treatment in children to prevent sleep-disordered breathing in adulthood

“…(1) Short anterior cranial base [33][34][35]43] (2) Less obtuse cranial base flexture angle [36,37] (3) Retropositioned mandible [33,36,[38][39][40][41]43] (4) Small mandible [34,35,41,42] (5) Small maxilla [34,35,43] (6) Steep mandibular plane [38,44] (7) Long soft palate [33,36,40,45] (8) Decreased airway space [34,36,38,40,44] (9) Lowered position of hyoid bone [36,40,43,44,46] (10)Increased anterior facial height [33,38,40,43,44].…”