Long-term effect of neonatal endotracheal intubation on palatal form and symmetry in 8-11-year-old children

Premature and low birth weight infants often require neonatal oral intubati on for resuscitation and to relieve respiratory distress. The endotracheal tube exerts pressure on the developing palate, which can result in palatal groove formation, a high-arched palate, and palatal asymmetry. The purpose of this investigation was to determine whether such intubation can have a l ong-term effect on palatal form and symmetry. Arch widths, palatal widths, and palatal depths were measured from the stud y casts of 43, 8-11-year-old previously intubated premature and low birth w eight children using a reflex microscope, with a fixed rectangular Cartesia n co-ordinate system, and compared with a group of non-intubated gender- an d age-matched controls. Significant differences were found between the intubated and non-intubated children. The intubated children had significantly narrower palatal widths posteriorly (P less than or equal to 0.001), steeper palatal vaults anterio rly (P less than or equal to 0.01), and exhibited a directional palatal wid th asymmetry with the left side of the palate measuring consistently wider than the right. These differences did not, however, appear to be affected b y the length of intubation. Therefore, it is concluded that an oral endotracheal tube might exert exces s force on the developing alveolus anteriorly with the tube being displaced to the right of the palate posteriorly leading to a steep anterior palatal vault and a left-sided palatal asymmetry, which can persist until the age of 11 years of age.