Upper Airway Obstruction and Upper Airway Deformaties – Part 3

by James F. Garry, D.D.S.

Harvold, in his research with primates, demonstrated that a reduction of tongue size is followed by a corresponding collapse of the dental arches. He found that the tongue could change shape with a plastic insert in the palate. This demonstrated that the shape of the tongue partially depends on its contact with surrounding structures. He found that when a tongue is carried into a new position the distribution of its forces will be altered against the teeth for several months. The teeth, in turn, changed position in response to the new force system with concomitant dental arch changes. Harvold concluded that the extent to which the tongue alters its shape to fit the dental arches depends upon the relative significance of the particular sensation of tooth contact compared with the other sensory inputs. The proprioceptive response of the dorsum of the tongue from hypertrophied adenoids and/or enlarged tonsils may elicit dominant sensory stimuli resulting in a non-physiologic position of the tongue within the dental arches. It has been the author’s clinical experience that all chronic mouthbreathers develop a malocclusion.

Reference: Harvold BP: The Activator inINterceptive Orthopedics, St. Louis: C.V. Mosby Co.;1964;57-63.

Waldeyers Ring

Despite protestations from pediatricians, clinical investigators have failed to demonstrate significant changes in the immunologic status of patients following tonsillectomy and adenoidectomy.

Palatine Tonsils

Almond shaped masses located between the anterior pillars (palatoglossal muscles) and posterior pillars (palatopharyngeal muscles).

Lingual Tonsils

Collection of lymph follicles located at the root of the tongue.

Adenoids

The soft palate has been displaced superiorly with a retractor displaying a large mass of adenoid tissue on the posterior pharyngeal wall of the nasopharynx.

Adult Nasopharynx

View of the adult nasopharynx taken from one of the nasal passages.

Lateral X-ray of Nasopharynx Showing Adenoid Hypertrophy

Acute Hemorrhagic Tonsillitis

Increased bacterial activity produces intense superficial necrosis and ulceration of the mucosa.

Hypertrophy of Palatine Tonsils

Shows marked erythema and edema of the retrotonsillar tissue including the soft palate.
Note the wide deep crypts.

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