The preliminary results of the differences in craniofacial and airway morphology between preterm and full-term children with obstructive sleep apnea

Abstract

Background/purpose The prematurely born and obstructive sleep apnea (OSA) could affect craniofacial and airway growth. The purpose of this study is to compare the differences in craniofacial and airway morphology between preterm and full-term children both with OSA problem. Materials and methods The differences in craniofacial and airway morphology between preterm children and full-term children both with OSA problem during the prepubertal (age 6–10) and pubertal (age 11–14) period were measured using lateral cephalometric radiograph. Results In the prepubertal period, effective maxillary length, and length from Go to Gn were smaller in the preterm group (n = 6) compared to the full-term (n = 8). The length of the soft palate was smaller and the distance soft palate-posterior side of nasopharynx was longer in preterm children. During puberty, (1) position of maxilla relative to cranial base: there was an anteroposterior maxilla and a mandibular discrepancy, a convexity of facial profile, (2) the distance from point A to nasion perpendicular, the distance from Pog to nasion perpendicular, and the ratio of effective maxillary length/effective mandibular length were smaller in the preterm group (n = 5) compare to the full-term (n = 6). Conclusion During prepuberty, the preterm children had a significantly shorter effective maxillary and mandibular length but the catch up growth resulted during the pubertal period in reduction in facial profile convexity and more important mandibular vertical growth toward a dolichocephalic profile. Due to preterm birth, OSA children have a different craniofacial morphology compared to the full-term. When using an oral device for passive myofunctional therapy, the treatment outcome maybe different.

Retrospective analysis of inpatient polysomnogram characteristics and discharge outcomes in infants with bronchopulmonary dysplasia requiring home oxygen therapy

“…Additionally, studies have found evidence of upper airway remodeling in preterm infants, which may result in OSA and contribute to an increased OAHI. 27,28 Although infants with BPD may have a component of OSA, this elevated OAHI may not be solely due to airways obstruction, secondary to altered anatomy. It is worth noting, as discussed earlier, that OAHI can very well be underestimated, as almost all of the studies were titration studies.…”

“…We did not routinely perform or examine bronchoscopy findings (if done) in our patient population, but it is plausible that a portion of our population likely has tracheobronchomalacia, which may contribute to the degree of obstructive sleep apnea (OSA) that is observed here. Additionally, studies have found evidence of upper airway remodeling in preterm infants, which may result in OSA and contribute to an increased OAHI 27,28 . Although infants with BPD may have a component of OSA, this elevated OAHI may not be solely due to airways obstruction, secondary to altered anatomy.…”

Correlation of facial anthropometry data of late preterm newborns and oral feeding readiness

“…Research that evaluated individuals between 6 and 14 years of age with obstructive sleep apnea, who were born prematurely and at term, concluded that premature newborns have a different craniofacial morphology when compared to term newborns, suggesting dolichofacial morphology (14) .…”

Características da cavidade oral edêntula e do crescimento orofacial dos lactentes nascidos pré-termo de muito baixo peso

“…Os demais autores: Clinch 84 , Flinck et al 73 , Dinis et al 74 , George et al 76 Fato interessante sobre o crescimento da face em indivíduos nascidos prematuros com idade entre 2 e 32 anos de idade, foi o estudo de Van Erum et al 117 , realizado por meio de traçados cefalométricos com radiografias em norma lateral (telerradiografias) analisando o crescimento craniofacial, que mostraram um retrognatismo mandibular (trespasse horizontal) com altura facial aumentada, resultando em um padrão facial típico divergente (face comprida). No mesmo nível de importância, encontram-se os estudos de Lian et al 118 Maaniitty et al 122 indicou que, na dentição decídua, a prevalência de oclusopatias variava muito entre crianças nascidas muito prematuras e a termo, e na dentição mista precoce, não apresentava diferenças estatisticamente significativas nas características oclusais; no entanto, as crianças prematuras eram significativamente mais propensas a terem recebido tratamento ortodôntico. Um outro alerta significativo foi o estudo de Pithon et al 123 , em crianças brasileiras entre 8 e 10 anos de idade, que afirmaram que a oclusopatia do tipo mordida aberta teria impacto negativo na qualidade de vida infantil.…”

“…Um outro alerta significativo foi o estudo de Pithon et al 123 , em crianças brasileiras entre 8 e 10 anos de idade, que afirmaram que a oclusopatia do tipo mordida aberta teria impacto negativo na qualidade de vida infantil. Os achados citados acima de Paulsson, Söderfeldt e Bondemark 94 , Harila et al 116 , Van Erum et al 117 , Lian et al 118 , Paulsson e Bondemark 119 , Rythén 15 , Germa et al 120 , Objois e Gebeile-Chauty 121 e Maaniitty et al 122 assemelham-se aos resultados deste estudo, que mostrou diferença estatisticamente significativa na proporção facial e na oclusão dos rodetes gengivais nos nascidos prematuros de muito baixo peso quando comparados aos nascidos a termo.…”