Non-invasive ventilation treatment and craniofacial growth in children: A scoping review.

PURPOSE: To summarize current evidence and identify knowledge gaps regarding the craniofacial consequences of non-invasive ventilation (NIV) treatment in children.

METHODS

An electronic search was performed in six databases according to PCC strategy. Studies that evaluated children as Population (P), craniofacial growth as Concept (C) and NIV treatment as Context (C) met the eligibility criteria. The citations were exported to a reference manager and screened. The data was extracted by two reviewers, and the synthesis of results was presented in a narrative way.

RESULTS

A total of 7,476 references were identified. Eight studies met the eligibility criteria and were included. The most common NIV interface was the nasal mask, and the Continuous Positive Airway Pressure (CPAP) was the most used type. The impact on maxillary growth was observed as negative in five studies, and not significant for the other two studies. The impact on mandibular growth was negative in one study and positive in another. The growth impact was also negative for the frontal bone and tooth position, while a non-significant impact was observed for facial convexity.

CONCLUSIONS

NIV can be associated with dimensional changes in midface such as maxillary shortening and hypoplasia. However, NIV interfaces, pressure levels, and the association with comorbidities should be analyzed in future longitudinal standardized studies to understand their real impact, focusing on long-term assessment of craniofacial features.