The adenoid facies describes a constellation of facial findings rich in misunderstandings.


A key clinical finding is mouthbreathing due to nasal airway obstruction. Since enlarged adenoids are common in children and can cause nasal airway obstruction, the term "adenoid" crept in.


The term "adenoid facies" applies to a person with:

(1) the long face syndrome (face long and narrow, dolichofacial)

(2) narrow nose and nasal passages

(3) malar hypoplasia

(4) narrow maxillary arch

(5) open mouth breathing

(6) protrusion of maxillary incisors

(7) high-arched palate

(8) angle class II malocclusion

(9) flaccid lips


The tip of the nose may be raised superiorly ("nose stuck up in the air") and the face may seem expressionless.


One theory is that the malformations are a consequence of the airway obstruction and not the cause. Proponents argue that early correction of airway obstruction can prevent the abnormal facial development. The unanswered question here is which came first.


A patient with adenoid facies is at risk for a number of problems including:

(1) obstructive sleep apnea

(2) dental malocclusion

(3) difficult intubation


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