Prevalence of adenoid hypertrophy among 12-year-old children and its association with craniofacial characteristics: a cross-sectional study

Background Identifying the prevalence of adenoid hypertrophy (AH) and craniofacial factors associated with this condition requires studies with random sampling from the general population, and multiple criteria can be used for assessing AH on lateral cephalometric radiograph (LCR). The present analysis represents the first report performed according to these requirements in a large cross-sectional sample of children. Methods LCRs of 517 12-year-old children (286 males, 231 females) randomly selected from the general population were retrospectively retrieved. AH was defined using three criteria (At/Nd, Ad-Ba/PNS-Ba, 1-Npaa/Npa), and twelve craniofacial variables were measured (SNA, SNB, ANB, Wits, Cd-Gn, MnP^SN, MxP^MnP, TPFH/TAFH, OPT^SN, C2ps-C4pi^SN, H-CV, H-FH). Skeletal characteristics were compared between children with and without AH using Mann–Whitney U test. Binary logistic regression (adjusted for sex and skeletal growth) was used to independently quantify the association between craniofacial factors and AH. Results The prevalence of children with AH was 17.6% (according to At/Nd), 19.0% (according to Ad-Ba/PNS-Ba), and 13.9% (according to 1-Npaa/Npa). Children with AH presented greater antero-posterior jaw discrepancy (larger ANB, smaller SNB), greater mandibular divergence (larger MnP^SN), forward head posture (larger OPT^SN and C2ps-C4pi^SN), and anteriorly positioned hyoid bone (larger H-CV). Larger SNA (OR = 1.39–1.48), while smaller SNB (OR = 0.77–0.88) and Wits (OR = 0.85–0.87), were associated with greater likelihood of having AH, independently from the assessment method used. Conclusions The prevalence of children with AH ranged from 13.9 to 19.0% based on LCR. Greater antero-posterior maxillo–mandibular discrepancy and mandibular retrusion were independently associated with higher likelihood of having AH.