Craniofacial Growth Modification for OSA Children

Oh, Seung-Wook; Kim, Su-Jung

doi:2021.59.8.440

J Korean Dent Assoc > Volume 59(8); 2021 > Article

Journal of Korean Dental Association 2021;59(8):440-447.
DOI: https://doi.org/10.22974/jkda.2021.59.8.002 Published online July 31, 2021.

소아 수면장애호흡 환자의 악안면 성장조절 교정치료

오승욱

, 김수정

경희대학교 치과대학

Craniofacial Growth Modification for OSA Children

Seung-Wook Oh

, Su-Jung Kim

Department of Orthodontics, School of Dentistry, Kyung Hee University

Correspondence: Su-Jung Kim, Tel: +82-2-958-9390,
Email: ksj113@khu.ac.kr

Abstract

Pediatric sleep disordered breathing (SDB) includes snoring and obstructive sleep apnea (OSA) in growing children. Because diagnostic criteria and subjective symptoms of OSA in children differ from those in adults, different diagnostic and therapeutic approach is necessary. Based on the differential growth of craniofacial struc-ture and upper airway soft tissues, phenotype-based, timely-target intervention is needed to interrupt abnormal craniofacial growth inducing or aggravating SDB symptoms and ultimately to prevent the progression to adult- hood OSA. Although adenotonsillar hypertrophy is known to be first-line treatment in pediatric OSA patients, craniofacial growth modification treatment needs to be primarily considered for the patients with craniofacial skeletal phenotypic cause. Growth modification treatment can be categorized into four modalities depending on the craniofacial target related to the upper airway collapsibility: 1) Unlocking the mandibular growth for skeletal Class II patients with retruded small mandible; 2) Nasomaxillary protraction for skeletal Class III pa- tients with deficient midface; 3) Nasomaxillary expansion for the patients with transverse discrepancy and nasal obstruction; 4) Control of vertical maxillary excess in patients with long face and structural mouth breathing.

Key Words: Sleep disordered breathing(SDB); Obstructive sleep apnea(OSA)