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923
CORRELATION ASSESSMENT OF CEPHALOMETRIC PARAMETERS OF
CHILDREN 3-11 YEARS OLD AND CHILDREN WITH ADENOID HYPERTROPHY
Alimova Nigina Pulatovna
Bukhara State Medical Institute
Uzbekistan
E-mail:
ORCID ID: 0000-0002-9665-226X
Annotation:
The proportion of children with chronic adenotonsillitis varies 20-50%, and among
frequently ill children these diseases are 37-70%. This indicates an increase in hypertrophy of the
pharyngeal tonsil, an increase in the frequency of adenoid pathology in children, which adversely
affects the structural formation of the jaw complex. It has been revealed that the influence of a
long-term course of diseases in children leads to a violation of the formation of the facial
skeleton, which is reflected in the form of a sagging lower jaw. the formation of its narrow and
distant, improper development of the hard palate and occlusion. In the development of
dentoalveolar anomalies at the age of 8-10 years, a significant role is played by diseases of the
ENT organs, in particular, the proliferation of adenoids.
Keywords:
cephalometry, adenoid hypertrophy, children, correlation
Objective:
to analyze the correlation between cephalometric parameters of children aged 3-11
years and children with adenoid hypertrophy
Materials and methods:
421 children with adenoids in the city of Bukhara aged 3-11 years
were examined. The subject of the research was the anthropometric parameters of the head and
face.
Introduction.
Although there are advances in the diagnosis and treatment of adenoids in
children, they are diagnosed quite late. As a result, this harms the quality of treatment of patients
(Skordis N et al., 2012).
The growth and development of the human div from the embryonic stage to its adult state is a
very complex phenomenon consisting of many changes under the neurohumoral regulatory
mechanisms that control the differentiation, development and maturation of organs and systems.
Various reasons such as familial and pathological can affect the growth parameters of various
parts of the human div
Knowledge of the patterns of growth and development of facial bones will help prevent an
increase in the number of disorders in the maxillofacial area (D.A. Domenyuk, 2016).
The number of works devoted to the study of the morphogenesis of the craniofacial complex in
childhood in one or another pathology, especially in hypertrophy of the pharyngeal tonsil, is
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extremely limited. It is known from the literature that the maxillofacial area undergoes radical
transformations in the process of development. (V.T. Yagupova, 2019).
In the literature, it is shown that mental stress (Lukina S.F. et al., 2012) affects the physical and
functional development of children (Mazen Mohammed Youssef Hassan Hussein., 2014).
The mechanisms that regulate the growth of the human head and face are complex processes
where there is an interaction between hormones and epigenetic factors. The above factors
determine the formation of craniofacial bones, the violation of which can lead to irreversible
changes in this area (Juloski J. et al., 2016).
With a violation of the interaction of regulatory factors for the growth of the bones of the facial
skeleton, there is an unequal slowdown in bone growth, which leads to anomalies in the
formation of the face. In various genetic abnormalities or syndromic pathologies, there is a lag in
the development of the dentition (Haynes A, Bulsara MK., 2012).
Knowledge of facial dysmorphic features is important in the diagnosis of many congenital
diseases, such as Down syndrome or fetal alcoholic disease (Koca C.F. et al, 2016, Suttie M. et
al, 2018). Some chronic diseases that occur during the development period can lead to
abnormalities in facial parameters. A group particularly susceptible to the development of
craniofacial anomalies are children with chronic nasopharyngeal obstruction, who often have
mouth breathing. In the long term, mouth breathing can lead to an increase in the anterior height
of the face, a retrognatic mandible, a steep angle of the mandible, lip incompetence and narrow
maxillary and mandibular dental arches. The combination of these changes is usually called an
"adenoid face" because it is characteristic of children with hypertrophy of the adenoids and
tonsils (Nagaeva T.A. et al., 2016, Tastanova G. et al., 2021, Koval Yu.N. et al., 2021).
The mechanistic nature of abnormal facial growth in children is a consequence of adenotonsillar
hypertrophy. The classical model suggests that an unclear inflammatory process or infection
leads to hypertrophy of the adenoids or tonsils. Enlarged adenoids and tonsils block the upper
airways and force the child to breathe through the mouth. (Arsenina O. I. et al. 2014) due to
weak stimulation of local bones (Pawłowska-Seredyńska K. et al. 2020, Chuang H. H. et al.
2020).
An open mouth often results in a downward position of the tongue, which can lead to a low
position of the lower jaw and head. However, there is evidence that children with adenoids and
tonsil hypertrophy have abnormal nocturnal hormone secretion. It has been proven that a
decrease in growth hormone secretion may be associated with the posterior size of the face due
to the short branch of the lower jaw (Tastanova G.E., Khodzhanov Sh., 2021).
Results of the study:
The analysis of the data obtained revealed a different correlation between
the cephalometric parameters of children.
In healthy 3-year-old children, there was a strong correlation between the longitudinal diameter
of the head and the head circumference (r=0.80), and in children with adenoids, there were
medium relationships between the physiognomic and morphological heights of the face, with
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the height of the nose (r=0.51-0.59), as well as the interorbital width and diameter of the lower
jaw, zygomatic diameter (r=0.38-0.49).
In 4-year-old children with hypertrophy of the pharyngeal tonsil, a moderate correlation was
found between the transverse diameter of the head and the circumference of the head,
zygomatic and mandibular width (r=0.56-0.70); and in practically healthy children, the
physiognomic and morphological heights of the face are associated with an average correlation
with the longitudinal diameter of the head (r=0.26-0.43)
In 5-year-old practically healthy children, the height of the nose is associated with the height of
the mucous membrane of the lips, the morphological height of the face and the diameter of the
lower jaw are weakly related to the zygomatic and external orbital width, (r=0.510.61), in
children with adenoid overgrowth, a moderate correlation was observed with the longitudinal
and transverse diameters of the head, physiognomic height of the face, width and height of the
nose (r=0.340.49).
In 6-year-old children with adenoid hypertrophy, head circumference had a strong correlation
with the longitudinal diameter of the head (r=0.80), and a moderate relationship was observed
in the control group between the transverse diameter of the head, forehead height,
physiognomic and morphological heights of the face (r=0.70.56).
A strong correlation was found between physiognomic height and head circumference at 7
years of age in children in the control group, and in children with adenoids there was a strong
correlation between the height and width of the nose, as well as zygomatic and mandibular
diameter (r=0.530.70), but a moderate correlation was found between the transverse diameter
of the head and the height of the forehead (r=0.350.50).
In 8-year-old children with adenoid hypertrophy, the height of the forehead is strongly related
to the morphological height of the face, head circumference (r=0.750.90), in the children of the
control group, a mean correlation of head circumference with the longitudinal diameter of the
head, height of the nose and lips, physiognomic height of the face, zygomatic and mandibular
diameter (r=0.590.72) was revealed.
Table 1
Comparative assessment of the correlation of children's facial parameters according to
Pearson
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926
M
D
Zy
go
m
at
ic
di
am
et
er
M
an
di
bu
la
rd
ia
m
et
er
M
or
ph
ol
og
ic
al
he
ig
ht
of
th
e
fa
ce
Ph
ys
io
lo
gi
ca
lh
ei
gh
to
ft
he
fa
ce
N
os
e
he
ig
ht
N
os
e
w
id
th
O
ut
er
or
bi
ta
lw
id
th
In
te
ro
rb
ita
lw
id
th
H
ei
gh
to
ft
he
m
uc
ou
sm
em
br
an
e
of
bo
th
lip
s
M
ou
th
w
id
th
Zygomatic
diameter
1
,783
**
,175
*
,363
**
,517
**
,243
**
,504
**
,393
**
,352
**
,509
**
Mandibular
diameter
,760
**
1
,197
**
,446
**
,531
**
,285
**
,595
**
,501
**
,395
**
,605
**
Morphological
height of the
face
,280
**
,343
**
1
,270
**
,451
**
,107
,249
**
,069
-,074 ,374
**
Physiological
height of the
face
,298
**
,279
**
,337
**
1
,308
**
,392
**
,170
*
,562
**
,418
**
,361
**
Nose height
,591
**
,533
**
,184
**
,287
**
1
,310
**
,544
**
,345
**
,290
**
,686
**
Nose width
,324
**
,467
**
,235
**
,386
**
,375
**
1
,092
,547
**
,510
**
,467
**
Outer orbital
width
,569
**
,609
**
,342
**
,317
**
,271
**
,290
**
1
,330
**
,372
**
,441
**
Interorbital
width
,359
**
,421
**
,121
,274
**
,492
**
,400
**
,147
*
1
,740
**
,483
**
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927
Height of the
mucous
membrane of
both lips
,231
**
,187
**
,104
,368
**
,119
,381
**
,372
**
,220
**
1
,407
**
Mouth width
,722
**
,745
**
,398
**
,354
**
,473
**
,312
**
,619
**
,268
**
,263
**
1
Note:**. The correlation is significant at the level of 0.01 (bilateral).*. The correlation is
significant at the level of 0.05 (bilateral).
In 9-year-old healthy children, the morphological height of the face forms an average
correlation only with the physiognomic height of the face (r = 0.54). In children with
overgrowth of adenoids, weak
the relationship between the zygomatic and mandibular diameters (r=0.190.11).
In 10-year-old children with adenoid hypertrophy, the physiognomic height of the face is
associated with an average correlation with head circumference, nasal width and morphological
height of the face, zygomatic width and height of the nose (r=0.510.73). In healthy children
Moderate connections were found with longitudinal and transverse diameters of the head,
mandibular width.
In practically healthy children of 11 years of age, the morphological height of the face is
strongly correlated only with the transverse size of the forehead (r=0.360.41). The average
correlation was found with head circumference, longitudinal diameter of the head, zygomatic
diameter and jaw width. In children with adenoids, a strong correlation was found linking the
studied parameter of morphological height of the face with the physiognomic height of the face,
the width of the lower jaw (r=0.510.72).
Conclusions:
Thus, the cephalometric parameters of children 3-11 are interconnected by
correlations of different strength and direction. In practically healthy children, strong correlations
were found between the circumference of the head and its longitudinal diameter; morphological
height of the face and height of the lower part of the face, depth of the face and height of the
mandibular branch; and children with adenoids between zygomatic and jaw width; depth of the
face and length of the div of the lower jaw; height of the div and branch of the mandible; and
the length of the div of the lower jaw (r=0.750.90).
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