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In this study we determined whether craniofacial development in rats could be influenced by an early temporary (3 d) nasal obstruction associated with forced oral breathing. The rats were killed at specific time points after surgery. Plasma samples were taken for biochemical analyses, and cephalometric measurements were performed. Shortly after nasal obstruction, the vertical nasomaxillary complex and the longitudinal skull base proved to be smaller in both sexes of test rats compared with controls. This was maintained in male rats but not in female rats. In female rats, only the longitudinal skull base remained somewhat shorter as the animals grew older. Reversible nasal obstruction was further associated with reduced dimensions of the olfactory bulbs lasting into adulthood and an initial decrease in lung weight. One day after implementing nasal obstruction, basal corticosterone levels had increased (by over 1,000%) and stayed at a high level in female rats. In male rats, however, the corticosterone level seemed to return to normal by day 90. Oral breathing was also associated with a lower level of thyroid hormone, especially at the shorter term intervals in both sexes. We conclude that a 3-d nasal obstruction period in young rats leads to long-term hormonal changes and to craniofacial structural adaptation., (© 2011 Eur J Oral Sci.)

The effects of functional endoscopic sinus surgery (FESS) on sinus and midfacial development remain unclear. The authors report five children who, at a median age of 30 months, underwent FESS for refractory sinusitis. Three of the children had cystic fibrosis, and two had asthma. Preoperative computed tomographic (CT) scanning showed symmetric maxillary sinus development with varying degrees of mucosal disease. At a mean of 42 months after surgery, CT scans were obtained to evaluate recurrent symptoms in the five children. The scans showed unilateral maxillary hypoplasia in four children and bilateral maxillary sinus hypoplasia in one child. No child had clinically apparent facial asymmetry or midfacial hypoplasia. The authors also discuss the factors involved in maxillary sinus pneumatization, the possible effects of sinus surgery on sinus development, and the clinical implications of "acquired" maxillary sinus hypoplasia.

Maxillary sinusitis appears to be more prevalent in the cleft palate population than in the normal population. The increase in sinusitis may be due to the fact that the maxillary sinus develops differently embryonically in cleft palate patients than in those patients with normal palates. A double blind study was done by measuring the maxillary sinus cephalometric x-rays in cleft palate patients and then comparing them to patients with normally developed palates. The groups studied were 3 months to 20 years of age. It was concluded that in each of these groups there was no significant difference in size, shape, or rate of development of the maxillary sinus in cleft palate patients compared to the normal population. It is probable that the increased incidence of maxillary sinusitis in cleft palate patients is due mainly to the open palate with constant contamination of the nasal mucosa by food pushed into the nares and sinus ostia, resulting in maxillary sinusitis.