Ocorrência da síndrome da apneia obstrutiva do sono (SAOS) em crianças respiradoras orais

Abstract

It is well known that mouth breathing is associated with adenotonsillar hypertrophy -which is the main cause of obstructive sleep apnea among children. Despite the importance of this matter, there are only a handful of studies showing the relationship between OSAS and mouth breathing.Aim: to determine the prevalence of obstructive sleep disorders in mouth breathing children and study its correlation with otorhinolaryngological findings. Study design: Retrospective cohort study.Method: Data analysis from 248 medical charts of mouth breathing children seen at the Pediatric Otolaryngologic Division of a large medical institution between the years of 2000 and 2006. All patients had nasofibroscopy and or Cavum radiographs and polysomnographic exams. According to the Apnea index, patients were classified as primary snorers (AI<1); and as OSAS (≥1). Results:From 248 patients included in the study, 144 (58%) were primary snorers and 104 (42%) had OSAS. The most prevalent otorhinolaryngological findings were adenotonsillar hypertrophy (n=152; 61.2%), tonsilar hypertrophy (n=17; 6.8%), adenoid hypertrophy (n=37; 14.9%), rhinitis (n=155; 62.5%) and secretory otitis (n=36; 14.5%).Conclusions: primary snoring and OSAS are frequent findings in mouth breathing children. The most frequent otorhinolaryngological disorder in children with OSAS is adenotonsillar hypertrophy with or without rhinitis. Braz J Otorhinolaryngol. 2010;76(5):552-6. ORIGINAL ARTICLE BJORL

Unilateral Nasal Obstruction during Later Growth Periods Affects Craniofacial Muscles in Rats

“…Moreover, the number of cases of respiratory complications related to allergic rhinitis and obstructive sleep apnea is increasing, especially during preadolescence and adolescence growth periods (Abreu et al, 2008; Juliano et al, 2009; Izu et al, 2010). The earlier the nasal obstruction develops, the earlier associated alterations can occur, not only in the respiratory system, but also in the whole body.…”

“…Experimental studies have elucidated that nasal obstruction induces a significant reduction in the vertical development of the nasomaxillary complex and skull base along the longitudinal axis (Scarano et al, 1998). It also results in a significant reduction in the growth of the masseter and the anterior digastric (Dig) muscle (Gelhaye et al, 2006; Izu et al, 2010). With regard to masticatory function (Hsu and Yamaguchi, 2012; Ikenaga et al, 2013), previous studies have shown that oral breathing reduces masseter muscle activity (Ferla et al, 2008), and increases suprahyoid muscle activity and hypotonia of the lips and buccinator muscle (Valera et al, 2003).…”

Dimensões nasofaríngeas e sintomas respiratórios após a cirurgia de retalho faríngeo em crianças e adultos

“…Some factors that may justify this fact could also be investigated, such as the presence of a higher incidence of upper airway infections (28) and hypertrophic tonsils and adenoids in this age group (29) , which can aggravate respiratory symptoms (30) . Furthermore, the presence in the children's group of a caregiver or other person responsible for information about symptoms favors a detailed account of respiratory signs and symptoms during sleep, which is not available in the case of many young adults.…”

Significant association between SCGB1D4 gene polymorphisms and susceptibility to adenoid hypertrophy in a pediatric population*

“…The adenoids, also known as pharyngeal or nasopharyngeal tonsils, are important components of the Waldeyer's ring (1). Adenoid hypertrophy (AH) is enlargement of the adenoids; it is frequent in the pediatric population and can cause symptoms such as mouth breathing, nasal obstruction, hyponasal speech, snoring, and sleepdisordered breathing (SDB) (2)(3)(4). The exact mechanisms underlying AH remain extremely poorly understood, but it has been assumed that recurrent or chronic inflammation plays a role (5).…”