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Dentofacial Development in Children with Chronic Nasal Respiratory Obstruction -- a Cephalometric Study

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Dentofacial Development in Children with Chronic Nasal Respiratory Obstruction -- a Cephalometric Study Loyola University Chicago Loyola eCommons Master's Theses Theses and Dissertations 1989 Dentofacial Development in Children with Chronic Nasal Respiratory Obstruction -- a Cephalometric Study Tai-Yang Hsi Loyola University Chicago Follow this and additional works at: https://ecommons.luc.edu/luc_theses Part of the Dentistry Commons Recommended Citation Hsi, Tai-Yang, "Dentofacial Development in Children with Chronic Nasal Respiratory Obstruction -- a Cephalometric Study" (1989). Master's Theses. 3577. https://ecommons.luc.edu/luc_theses/3577 This Thesis is brought to you for free and open access by the Theses and Dissertations at Loyola eCommons. It has been accepted for inclusion in Master's Theses by an authorized administrator of Loyola eCommons. For more information, please contact [email protected]. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. Copyright © 1989 Tai-Yang Hsi DENTOFACIAL DEVELOPMENT IN CHILDREN WITH CHRONIC NASAL RESPIRATORY OBSTRUCTION -- A CEPHALOMETRIC STUDY by TAI-YANG HSI B.D.S. A Thesis Submitted to the Faculty of the Graduate School of Loyola University of Chicago in Partial Fulfillment of the Requirements for the Degree of Master of Science December 1989 ACKNOWLEDGEMENTS I would like to express my sincere gratitude and appreciation to the following people: To Dr. Lewis klapper, Chairman of Orthodontics, thesis director, for his support, guidance and instruction through this investigation. To Dr. Richard Port, assistance professor of Orthodontic department, for passing his original study to me and his instruction and assistance. To Dr. Michael Kiely, Professor of department of Anatomy, for his instruction and assistance. To Delia Vazquez, clinic coordinator of Orthodontic department, for her assistance to take all the head x-ray film of all the patients in this study. Special thanks would like to be given To Dr. Richard Bulger, the Ear, Nose.and Throat specialist, for his continuous support all the patients as experimental group make this study possible. To Bolton Growth Study Center of Case Western Reserve University, for supplying their head x-ray film as control group in this study. ii VITA Tai Yang Hsi was born in Taipei, Taiwan, Republic of China, on November 11, 1950. After graduation from high school, he enter Taipei Medical College, School of Dentistry and received his degree of Bachelor of Dental Science in June 1975. Upon graduating from Dental school, he served in the Army as reserved Dental Officer for two years. After discharging from the Army, he went to LuKu Health Center, the so­ called "No formal Health Provider - Village, as dentist for one year and then back to his hometown Taipei to open his own dental office. During those years of practicing as general practitioner, he has been the Broad of Director of Taipei Dental Association for four years, also been the Delegate of National Dental Association for two years devoting himself to dental public health and education. In September 1985, he entered the School of Public Health of Columbia University in New York city and major in dental public health for one year. In July 1989, he went to Loyola University, School of Dentistry as a post­ graduate student in the Orthodontic Department and also enrolled in the graduate program of Oral Biology. He received a certificate of specialty in Orthodontics .in December 1988. iii DEDICATION To my wife, my mother-in-law, and my brother whose supports to my family and the off ice plus encouragement made my study overseas possible. iv TABLE OF CONTENTS PAGE ACKNOWLEDGEMENTS ................................................................................ii VITA .................................................................................................................iii DEDICATION ..................................................................................................iV TABLE OF CONTENTS.................................................................................. V UST OF ILLUSTRATIONS.............................................................................. VI CHAPTER I. INTRODUCTION .......................................................................... 1 II. REVIEW OF UTERATURE........................................................... 4 (A}. ANATOMY, PHYSIOLOGY AND GROwrH ..............................4 (B}. ETIOLOGY, SYMPTOMS OF AIRWAY OBSTRUCTION .......... 14 (C}. AIRWAY OBSTRUCTION RELATED TO MOUTH BREATHING .. 16 (D}. RESPONSE CHAIN: TONGUE,NEUROMUSCUL.AR FUNCTION,. AND MANDIBLE POSTURE.......................... 20 (E}. CEPHALOMETRIC STUDIES................................................ 29 (F). TREATMENT..................•.........•..........................•................. 41 Ill. MATERIALS AND METHODS..................................................... .46 IV. RES ULTS ............................................................................ "' ......... 66 V. DISCUSSION .............................................................................79 VI. SUMMARY.................................................................................. 84 BIBLOGRAPH ................................................................................................86 v LIST OF ILLUSTRATIONS R~r~ P~e 1 Anatomy of upper airway ...........................................................................4 2 Anatomy of adenoid of adenoid tissue ..................................................... 5 3 Growth of nasopharynx in height and depth ........................................... 7 4 Growth of nasopharynx area ....................................................................8 5 Scammon•s curve of growth of the lymphoid tissue ............................... 9 6 Curve of growth of adenoid tissue .......................................................... 1O 7 Growth of Adenoid tissue, from infancy to adol~cence ........................ 11 a Growth cycle of adenoid tissue ............................................................... 11 9 Development of structure contigous to adenoid tissue .......................... 12 1o Development of excessive adenoid tissue .............................................. 12 11 Adenoid face ............................................................................................ 15 12 Adenoid face ............................................................................................ 15 13 Clinic test for nasal airway obstruction ................................................... 17 14 Antroadenoid and superioinferior diameter on lateral radiograph .......... 20 15 l\Jrway dimension measurement by Undr-Aronson/ Henrikson ............. 33 16 Diagram of airway dimension measurement by Linde-Aronson / Henrikson ..................................................................................................33 17 Diagram of airway dimension measurement by Under-Aronson / Henrikson ..................................................................................................34 18 Diagram of airway dimension measurement by Under-Aronson / Henrikson ..................................................................................................34 52 19 l\Jrway dimension measured by Cohn and Konak ...............................35 vi 20 Grapgic synopsis of six methods for measuring the size of adenoid .... 36 21 Ajrway measurement by Hibbert and whitehouse34 •••••••••••••••••••••••••••••••• 37 54 22 Adenoid measurement by Fujioka, Young, and Girdany •••••••••••••••••••••• 39 54 23 Nasopharynx measurement by Fujioka, Young, and Girdany ••••••.••••• .40 54 24 Adenoid/ Nasopharynx ratio by Fujioka, Young and Girdany •••••.•••• .40 25 History form used in the Ear, Nose and Throat clinic ........................... .47 26 Examination form used in the Ear, Nose and Throat clinic .................. .48 27 Case form used in the Ear, Nose and Thraot clinic .............................. .49 28 Sample of experimental group ................................................................. 51 29 Sample of control group .......................................................................... 51 30 Standard cephalometric machine: X-Ray beam source .......................... 52 31 Standard cephalometric machine: headstate .......................................... 52 32 Example of tracing of the head X-Ray plate ........................................... 53 33 Definition of anatomical landmarks for Ricketts facial pattern analysis .. 55 34 Definition of cephalometric planes for Ricketts facial pattern analysis .. 56 35 Definition of cephalometric measurement for Ricketts facial pattern analysis ................................................................. 56 36 Definition, clinic norm, and clinic deviation of facial axis and facial depth used in Ricketts facial pattern analysis ............................... 57 37 Definition, clinic norm, and clinic deviation of mandibular plane angle .. 57 38 Definition, clinic norm, and clinic deviation of mandibular arc ............... 58 39 Definition, clinic norm, and clinic deviation of lower facial height.. ......... 58 40 Tracing of the five measurements for facial pattern analysis in Ricketts facial pattern analysis .................................................................58 vii 41 Determination of Ricketts facial pattern analysis ..................................... 59 42 Example of determination of Ricketts facial pattern analysis .................. 60 43 Example of calculation of Ricketts facial pattern analysis
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