Influences of lymphoid tissues on facial pattern

Abstract Background The aim of this study was to investigate the specific contribution of enlarged tonsils or adenoids to craniofacial growth in children. Methods A total of 50 Japanese children (25 boys, 25 girls) at cervical vertebral maturation stage 2 or 3 were quantitatively evaluated regarding their level of obstruction by adenoidal and tonsillar tissues. We calculated the ratios of the cross-sectional areas of the adenoidal or tonsillar tissues to that of the pharyngeal airway using lateral cephalometric radiographs. The correlations between these ratios and several cephalometric variables were then examined using regression analysis. Results Children with a high ratio of cross-sectional area of adenoidal tissue to nasopharyngeal airway area had an increased mandibular plane (MP) angle and decreased articulare-gonion line, upper incisor–Frankfort horizontal plane line, and lower incisor–MP line dental measurements. In contrast, children with a high ratio of cross-sectional area of tonsillar tissue to oropharyngeal airway area had an increased MP angle and a decreased upper incisor–Frankfort horizontal plane line measurement. Conclusion(s) The results suggest that postpharyngeal lymphoid tissues might have partly specific, but partly indiscernible, effects on craniofacial growth. This finding must be considered when making an orthodontic diagnosis in patients at cervical vertebral maturation stage 2 or 3.