Adenoid facial type

The adenoid facial type is a typical set of symptoms with facial changes that develops in children as a result of prolonged nasal breathing disorders and the transition to constant mouth breathing.

These changes develop gradually as the facial skeleton grows and are not merely a cosmetic feature, but a clinical sign of chronic upper airway obstruction.

Aetiology and pathophysiology

The main cause is the presence of a mechanical obstruction in the nasal cavity or nasopharynx, most often adenoid hypertrophy (adenoid vegetation). Other causes may include chronic rhinitis, severe curvature of the nasal septum, or polyps.

The pathogenesis is related to the fact that constant mouth breathing alters the balance of the facial muscles. This leads to a predominance of vertical growth of the facial skeleton, narrowing of the upper jaw, formation of a high (“Gothic”) palate, and malocclusion.

Clinical Significance

The adenoid facial type is an important diagnostic marker indicating a serious and long-standing problem. Chronic nasal breathing problems can lead to hypoxia, sleep disorders (including obstructive sleep apnoea syndrome), frequent respiratory diseases and developmental delays.

Main signs include:

• Mouth constantly open;
• Elongated, narrow and puffy face;
• Smoothing of nasolabial folds;
• Development of malocclusion.

Timely detection and elimination of the cause (e.g., adenotomy) can stop the development of these changes and partially or completely reverse them, especially at an early age. Orthodontic treatment may be required at a later age.