ResumoObjetivo: Investigar a etiologia, as principais manifestações clínicas e as alterações presentes em crianças de 3 a 9 anos, respiradoras orais, residentes na região urbana de Abaeté (MG). Métodos:Estudo com amostra aleatória representativa da população do município de 23.596 habitantes. Clinicamente, foram consideradas respiradoras orais as crianças que roncavam, dormiam com a boca aberta, babavam no travesseiro e apresentavam queixas de obstrução nasal freqüente ou intermitente. As crianças com diagnóstico clínico de respirador oral foram submetidas a endoscopia nasal, teste alérgico cutâneo e raio X do cavum, hemograma, contagem de eosinófilos, dosagem de IgE total e parasitológico de fezes. Os dados foram analisados utilizando o programa SPSS ® versão 10.5. Resultados:As principais causas da respiração oral foram: rinite alérgica (81,4%), hipertrofia de adenóides (79,2%), hipertrofia de amígdalas (12,6%) e desvio obstrutivo do septo nasal (1,0%). As principais manifestações clínicas do respirador oral foram: dormir com a boca aberta (86%), roncar (79%), coçar o nariz (77%), babar no travesseiro (62%), dificuldade respiratória noturna ou sono agitado (62%), obstrução nasal (49%) e irritabilidade durante o dia (43%). Conclusão:Algumas manifestações clínicas são muito freqüentes na criança respiradora oral. Essas manifestações devem ser reconhecidas e consideradas no diagnóstico clínico da respiração oral.J Pediatr (Rio J). 2008;84(6):529-535: Prevalência, respiração oral, rinite alérgica, hipertrofia de adenóides, hipertrofia de amígdalas, desvio do septo nasal. diagnosis of mouth breathing underwent nasal endoscopy, allergy skin tests and X ray of the rhinopharynx, full blood tests, eosinophil counts, total IgE assay and fecal parasitology. Data were analyzed using SPSS ® version 10.5. Results:The main causes of mouth breathing were: allergic rhinitis (81.4%), enlarged adenoids (79.2%), enlarged tonsils (12.6%), and obstructive deviation of the nasal septum (1.0%). The main clinical manifestations of mouth breathers were: sleeping with mouth open (86%), snoring (79%), itchy nose (77%), drooling on the pillow (62%), nocturnal sleep problems or agitated sleep (62%), nasal obstruction (49%), and irritability during the day (43%). Conclusion:Certain clinical manifestations are very common among mouth-breathing children. These manifestations must be recognized and considered in the clinical diagnosis of mouth breathing.J Pediatr (Rio J). 2008;84(6):529-535: Prevalence, mouth breathing, allergic rhinitis, hypertrophic adenoids, hypertrophic tonsils, deviated nasal septum.
Objective: To investigate the etiology, main clinical manifestations and other concurrent findings in mouth-breathing children aged 3 to 9 years and resident in the urban area of Abaeté (MG), Brazil. Methods:This study was based on a representative random sample of the town population, of 23,596 inhabitants.Clinical diagnosis of mouth-breathing was defined as a combination of snoring, sleeping with mouth open, drooling on the pillow and frequent or intermittent nasal obstruction. Children with a clinical diagnosis of mouth-breathing underwent nasal endoscopy, allergy skin tests and X ray of the rhinopharynx, full blood tests, eosinophil counts, total IgE assay and fecal parasitology. Data were analyzed using SPSS ® version 10.5. Results:The main causes of mouth-breathing were: allergic rhinitis (81.4%), enlarged adenoids (79.2%), enlarged tonsils (12.6%), and obstructive deviation of the nasal septum (1.0%). The main clinical manifestations of mouth breathers were: sleeping with mouth open (86%), snoring (79%), itchy nose (77%), drooling on the pillow (62%), nocturnal sleep problems or agitated sleep (62%), nasal obstruction (49%), and irritability during the day (43%). Conclusion:Certain clinical manifestations are very common among mouth-breathing children. These manifestations must be recognized and considered in the clinical diagnosis of mouth-breathing.J Pediatr (Rio J). 2008;84(6):529-535: Prevalence, mouth-breathing, allergic rhinitis, hypertrophic adenoids, hypertrophic tonsils, deviated nasal septum.
Objetivo: Determinar a prevalência de crianças respiradoras orais com idade entre 3 a 9 anos residentes na região urbana de Abaeté (MG). Métodos: Estudo com amostra aleatória representativa da população do município, que é de 23.596 habitantes. Foram realizados sorteios através de tabela de números aleatórios até completar 370 crianças, número determinado por cálculo estatístico. Elaborou-se roteiro para anamnese e avaliação clínica dos pacientes, especificamente para esta pesquisa, pois não foi encontrado na literatura instrumento adequado e validado para esta finalidade. Os dados foram analisados utilizando o programa SPSS versão 10.5. Resultados: A prevalência da respiração oral foi determinada em 204 crianças (55%). Conclusão: São necessários estudos adicionais para validar questionário para o diagnóstico clínico de respiradores orais no nível primário de atendimento médico.
Objective: To determine the prevalence of mouth breathing among children aged 3 to 9 years living in the urban districts of the town of Abaeté, MG, Brazil.Methods: This study assesses a representative, randomized sample of the town's population (23,596 inhabitants).Children were selected by lots according to a random number table until 370 had been enrolled; this number had been determined by statistical calculation. A protocol for anamnesis and clinical assessment of the patients was specially developed for this project, since no preexisting instruments could be found in the literature that had been validated and were appropriate for the purpose. Data were analyzed using SPSS version 10.5. Results:The prevalence of mouth breathing was found to be 55%, or 204 children. Conclusion:Further studies are needed to validate a questionnaire for the clinical diagnosis of mouth breathers at the primary care level.
OBJECTIVE:To assess the suitability of referral from primary to secondary care in pediatric Otolaryngology. METHODS:The study was performed in the city of Belo Horizonte, in the state of Minas Gerais, from March 2004 to May 2005. A total of 408 pre-school children referred from primary care to secondary care in the department of Otolaryngology presenting with otitis, tonsillitis, sinusitis, allergic rhinitis, and tonsillar/adenoidal hypertrophy was assessed. The studied variables were: agreement between diagnoses in primary and secondary care; waiting time for doctor's appointment; follow-up, and professional (pediatrician or family physician) that examined children in primary care. Agreement of diagnoses was assessed using kappa statistics. RESULTS:Patients were fi ve years old on average, 214 (52.5%) were boys, mean waiting time for appointment was 3.7 months. Diagnoses in primary and secondary care were respectively: otitis (44%, 49%), tonsillar/adenoidal hypertrophy (22%, 33%), tonsillitis (18%, 23%), sinusitis (13%, 21%), allergic rhinitis (3%, 33%). Agreement analysis of kappa was 0.15 for otitis with effusion, 0.35 for recurrent otitis, 0.04 for tonsillar/adenoidal hypertrophy, 0.43 for tonsillitis, 0.05 for allergic rhinitis, and 0.2 for sinusitis. Diagnoses in primary care referred to secondary care were in agreement when given either by pediatrician or family physician. CONCLUSIONS:Unsuitability of referrals from primary to secondary care in Otolaryngology was expressed by the long time waiting for appointments and by the low agreement between diagnoses in different level of care for the same patients. Primary health care could be more effi cient if professionals were better qualifi ed in Otolaryngology.
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