Adenoid hypertrophy is the most common pathological cause of upper airway obstruction in children and may affect dental and maxillofacial development, leading to the more typical long face syndrome, known as adenoid hypertrophy facies.
The characteristic long face syndrome appearance can occur after adenoid hypertrophy. This appearance can simply be observed cosmetically with the head stretched forward, a relatively long face length, a short upper lip, and the presence of a relatively large arch curvature in the mouth, presenting an open mouth appearance. If we look inside the mouth, we can see that the teeth are crowded, with the upper row of teeth protruding in front of the lower row of teeth, similar to what is commonly referred to as “sky-over-ear”. In severe cases of adenoid hypertrophy, there is still a significant impact on facial development, which can seriously affect the appearance.
The main reason for the appearance of adenoids is that the disease can cause severe respiratory obstruction. Enlarged adenoids can, in severe cases, become the size of a ping-pong ball and completely block airflow through the nasal passages. Even if the enlarged adenoids are not large enough to completely block airflow, the person may feel the effort to breathe. These breathing problems can cause the person to stretch their head and open their mouth to help them breathe, resulting in the typical adenoid face.
The appearance of adenoid facies is a sign that adenoid hypertrophy has progressed to a severe level. It is important that treatment be provided in a timely manner. In less severe cases, the adenoid face may be relieved by surgical removal of the adenoids alone. In more severe cases or when irreversibility is expected, comprehensive treatment with oral and maxillofacial surgery is required.