P002 Retrospective CT review: does sinonasal disease affect paediatric orofacial morphology?

Abstract Background Mouth breathing in children, an incidence of 53%, has been associated with craniofacial changes such as a “long face” and narrowed maxilla. However, the causal direction remains debated with some studies suggesting mouth breathing leads to these changes, while others proposing that underlying craniofacial traits predispose individuals to nasal obstruction, making mouth breathing a secondary consequence. Much of the early research in this area relied on 2D cephalometry, however, CT can provide 3D imaging which allows for more accurate understanding. Methods A retrospective chart review was conducted on CT sinuses and facial bones performed at a tertiary referral centre and its affiliated sites in patients aged 0–18 years. Exclusion criteria included known craniofacial syndromes, prior or pending craniofacial surgery, or incomplete scans. Patients with a Lund-Mackay score > 5 or mucosal thickening >3 mm were classified into the radiological sinonasal disease subgroup. All scans were standardised using the Frankfurt Plane. Craniofacial measurements were taken using bony landmarks, including maxillary widths, palate height, piriform aperture dimensions, nasal depth, superior facial height, sagittal and coronal maxillary angle. These were compared to a normative group (Lund-Mackay ≤5). Generalised additive models were used to compare measurements while adjusting for age and sex. Results 193 normative scans (114 male, mean age = 9 ± 5.2) and 92 (59 male, mean age 6.5 ± 3.6) were analysed. Estimated differences ranged from a 3.8% decrease to a 1.0% increase in the subgroup relative to the normative group. None of these differences reached statistical significance (all p-values >0.05).