Deviations in facial form are discussed. On the basis of previously published hypotheses, it is suggested that oropharyngeal development may be influenced by the posture, and function of the tongue, lips, and jaws. Attention is drawn to the relationship between a firm tongue to palate swallow, and the pump action of the palatine aponeurosis, which it is suggested is necessary for the aeration of the Eustachian tube. The pump action appears to be reduced in long faced adenoidal children, but clinical evidence suggests that it can be regenerated by early Orthotropics (growth guidance) aimed at directing facial growth forward, instead of downward. Any reduction in the height of the face, facilitates an improved lip seal, without which the downward pattern of facial growth is likely to continue. On occasions when these objectives are achieved it would seem that sufficient room is created to align all 32 teeth, with excellent facial form, and little otolaryngological pathology.