Aims: To explore the effect of breathing disorders including asthma, atopy allergic rhinitis and sleep disordered breathing on face shape at age 15 years and to evaluate the effect of adenoidectomy and tonsillectomy on face shape.

Hypothesis: Breathing disorders, adenoidectomy and tonsillectomy have no effect on face shape in late adolescent.

Background: Respiratory activity may have an influence on craniofacial development and interact with genetic and environmental factors. It has been suggested that certain medical conditions such as asthma have an influence on face shape. Altered mechanics of breathing may influence the development of craniofacial structures and tends to result in significant changes in face shape particularly increased face height and retrusive mandible. However, removal of adenoids and tonsils has been reported to have a significant effect on obstructive breathing and if conducted early will normalize dentofacial morphology. ALSPAC provides the opportunity to explore a longitudinal data set with detailed facial morphology measures in late childhood on a large, representative sample.

Three-dimensional laser surface facial scans were obtained. Differences in the twenty-one reproducible facial landmarks (x, y, z co-ordinates) for the various groups will be evaluated as well as average facial shells will be created for asthmatic, atopic allergic rhinitis, sleep disordered breathing and healthy controls to explore surface differences.

Study design: observational longitudinal cohort study.

Confounding factors: height, weight, BMI, pubertal status.

Freeman K, Bonuck K 2012 Snoring, mouth-breathing, and apnea trajectories in a population-based cohort followed from infancy to 81 months: a cluster analysis. International Journal of Pediatric Otorhinolaryngology 76: 122-30

Jefferson Y 2010 Mouth breathing: adverse effects on facial growth, health, cademics and behavior. General Dentistry 58: 18-25

Wenzel A, Hojensgaard E, Henriksen J M 1985 Craniofacial morphology and head posture in children with asthma and perennial rhinitis. European Journal of Orthodontics 7: 83-92

Zettergren-Wijk L, Forsberg C M, Linder-Aronson S 2006 Changes in dentofacial morphology after adeno-/tonsillectomy in young children with obstructive sleep apnoea--a 5-year follow-up study. European Journal of Orthodontics 28: 319-26.