Facial soft tissues of mouth-breathing children: Do expectations meet reality?

Objective: To quantify the differences between the facial soft tissue morphology of severely obstructed mouth breathing (MB) and that of predominantly nasal breathing (NB) children. Methods: Soft tissue measurements were performed in the lateral cephalograms of 64 severely obstructed MB children (mean age 6.7 +/- 1.6) compared with 64 NB children (mean age 6.5 +/- 1.3). Groups were paired by age, gender, skeletal maturation status and sagittal skeletal pattern. Based on the assumption of normality and homoscedasticity, comparison of the means and medians of soft tissue measurements between the two groups was performed. Results: The facial convexity and anterior facial height ratio of MB were similar to NB children. The upper lip of MB children was protruded, and its base was thinner compared with NB; however, the length was not affected. The lower lip was shorter and more protruded in MB children. The nasolabial angle, nasal prominence, and chin thickness were smaller in MB children. Conclusions: The facial soft tissue of severely obstructed MB children is different than in NB children. Changes in lips, nasolabial angle, nasal prominence, and chin thickness are associated with severe airway obstruction in children. (C) 2014 Elsevier Ireland Ltd. All rights reserved.