Airway Obstruction and Maxillofacial Orthopedics

16

Maxilla

  • Dermal bone which develops from the ectoderm
  • Function effects Dermal bone growth

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Mandible

  • Chondral bone which develops from the mesoderm
  • Genes guide Chondral bone growth (body of mandible)
  • Alveolar bone is Dermal bone

Symptoms of Airway Obstruction

  1. Mouth Breathing
  2. Chapped Lips & Gingivitis
  3. Venous Pooling
  4. Head Posture
  5. Tonsil & Adenoids
  6. Reflux in the Eustachian
  7. Conductive Hearing Loss
  8. Head and Neck Pain
  9. Reduced Oxygen Blood Levels

Sleep – Disorder Breathing & Attention Deficit Hyperactivity Disorder

“Sleep-disorder breathing maybe the unsuspected cause of ADHD syndrome and its spectrum of problems. SDB may be misdiagnosed as ADHA.”

Journal of the American Medical Association, 2007; 297: (2681-2)

Patient 1

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29

Before

 1
 
2
 3

30

Modified Schwarz Appliance

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After

 Before1

After 2

 35
 37

Patient 2

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 1

Before

 40
 41
 42

Before

 Before1
After 2
 44
 3
 4
 5

After

 

45 Before

 46 After

Patient 2

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 48

 

Airway Patient. #3 The first cephalometric x-ray was made at the beginning of the child’s treatment as part of the initial diagnostic records.

The parent was advised that the child should have the adenoidal tissue remover to allow for proper nasal respiration, and the anterior tongue thrust corrected. The parent decided to delay the surgery.

The second cephalometric x-ray was made following initial airway surgery. Note the surgery removed only the oral pharyngeal obstruction. The nasal pharyngeal obstruction is still present.

The third cephalometric x-ray was made following the second surgery clearing the obstruction in the nasal pharyngeal airway. The two driving forces for normal facial growth and development are proper nasal respiration, and correct tongue function. This case is a classic example of the permanent damage that will occur when these two factors are ignored.

 2

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