Long-Term (>10 Years) Effects of Medical and Surgical Airway Obstruction Treatment on Dentofacial Morphology

Airway obstruction may lead to dentofacial dysmorphogenesis, with severity influenced by age, duration, and extent of obstruction. Aims: to evaluate long-term craniofacial changes in children with a history of mouth breathing, comparing outcomes between those treated with lymphoid tissue removal or with medication, and considering treatment age. Materials and Methods: Fifty-seven patients with a mean age of 19.09 years (range: 15.1–25.2 years) who had been evaluated in an earlier study (T1) were recalled at an average of 13 years follow-up (T2) and classified into a surgical group (n = 34), who had an adenoidectomy, and a non-surgical group (n = 23) treated with medication. Lateral cephalograms were obtained and compared with the original pre-treatment records. Control groups were included, matching the subjects in both groups for age and sex. Statistical analyses included group comparisons and associations among variables. Results: Significant improvement in both treatment groups were observed for the gonial angle (Ar-Go-Me), facial convexity (S-N-Me) and facial height (N-Gn), but T2-T1 changes in the surgical group were statistically significantly greater than in the medical therapy group. The palatal plane inclination to the horizontal (PP/H) and the mandibular plane inclination (MP/H) and to cranial base (MP/SN) were significantly improved in both groups (0.001 < p < 0.01). Conclusions: Both surgical and medical treatment of airway obstruction resulted in the reversal of the harmful effect of the obstruction. However, adenoidectomy was associated with greater improvements, possibly because the original obstruction was more severe and longer-standing. The results underline the importance of early recognition and management of airway obstruction to mitigate developmental orofacial dysmorphology.