Etiology, clinical manifestations and concurrent findings in mouth-breathing children

Abreu, Rubens Rafael; Rocha, Regina Lunardi; Lamounier, Joel Alves; Guerra, Ângela Francisca Marques

doi:10.2223/jped.1844

Cited by 84 publications

(92 citation statements)

References 14 publications

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“…The connection between sleep disordered breathing and an open mouth posture seems clear in this study as was the case in earlier studies [11,12,24]. However, surgery for snoring does not necessarily result in nasal breathing.…”

Section: Discussionsupporting

confidence: 81%

Development of craniofacial and dental arch morphology in relation to sleep disordered breathing from 4 to 12 years. Effects of adenotonsillar surgery

Lofstrand-Tidestrom

Hultcrantz

2010

International Journal of Pediatric Otorhinolaryngology

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Objectives: To study the development of craniofacial and dental-arch morphology in children with sleep disordered breathing in relation to adeno-tonsillar surgery. Subjects and method:From a community based cohort of 644 children, 393 answered questionnaires at age 4, 6 and 12 years. Out of this group, twenty-five children who were snoring regularly at age 4 could be followed up to age 12 together with 24 controls not snoring at age 4, 6 and 12 years. Study casts were obtained from cases and controls and lateral cephalograms from the cases. Analysis regarding facial features and dento-alveolar development was performed.Results: Children snoring regularly at age 4 showed reduced transversal width of the maxilla and more frequently had anterior open bite and lateral cross-bite than the controls. These conditions persisted for most cases at age six, by which time 18/25 had been operated for snoring. In most of the cases, surgery cured the snoring temporarily, but their width of the maxilla was still smaller by age 12-even when nasal breathing was attained. At age 12, the frequency of lateral cross-bite was much reduced and anterior open bite was resolved, both in cases and controls. The children who snored regularly at age 12 showed a long face anatomy and were oral breathers; this applied even to those who were operated. The seven cases who were not operated and the five who were still snoring in spite of surgery at age 12, did not have reduced maxillary width as compared to the controls. Conclusion:Dento-facial development in snoring children is not changed by adenotonsillar surgery regardless of symptom relief.

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Section: Discussionsupporting

confidence: 81%

Development of craniofacial and dental arch morphology in relation to sleep disordered breathing from 4 to 12 years. Effects of adenotonsillar surgery

Lofstrand-Tidestrom

Hultcrantz

2010

International Journal of Pediatric Otorhinolaryngology

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“…Em crianças e adolescentes sem doença de base, a prevalência para a hipertrofia de tonsilas palatinas levando a restrição de vias aéreas superiores tem sido relatada entre 11 e 12,6% 4,5 , ao passo que para tonsilas faríngeas, entre 30 e 37,6% 5,6 . Um dos mecanismos que podem justificar a elevada prevalência encontrada no nosso estudo corresponde a maior susceptibilidade a contrair infecções graves, a qual é devido a asplenia, diminuição da capacidade de opsonização, alterações do sistema reticuloendotelial e da função fagocítica [7][8][9][10] .…”

Section: Discussionunclassified

Association between adenotonsillar hypertrophy, tonsillitis and painful crises in sickle cell disease

Salles¹,

Ramos²,

Daltro³

et al. 2009

J Pediatr (Rio J)

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Objectives: To determine the prevalence of obstructive adenotonsillar hypertrophy in children and adolescents with sickle cell anemia; to investigate possible associations between the presence of more than five episodes of tonsillitis in the last 12 months and episodes of painful crises in the same period; and to compare the mean annual hemoglobin level in children and adolescents with and without obstructive adenotonsillar hypertrophy. Methods:Prospective, observational, cross-sectional study involving 85 children and adolescents with sickle cell anemia. All patients answered a questionnaire and underwent a standard otolaryngology examination, including endoscopic endonasal approach. The diagnosis of obstructive adenotonsillar hypertrophy was made according to the Brodsky scale. Results:The prevalence of obstructive adenotonsillar hypertrophy was 55.3%. Obstructive adenotonsillar hypertrophy was associated with history of difficulty in eating (76.7 vs. 23.5%, p = 0.003), presence of more than five episodes of tonsillitis in the last 12 months (70.6 vs. 29.4%, p = 0.021), loud snoring (73.0 vs. 27.0%, p = 0.004), and sleep apnea (71.8 vs. 28.2%, p = 0.005). Patients with obstructive adenotonsillar hypertrophy had more episodes of recurrent upper airway tract infection (62.5 vs. 37.5; p = 0.010). The presence of more than five episodes of tonsillitis in the last 12 months was associated with episodes of painful crises (median = 12 vs. 2, p = 0.017). There was no significant difference between mean annual hemoglobin levels of patients with obstructive adenotonsilar hypertrophy vs. nonobstructive adenotonsillar hypertrophy: 7.6 vs. 8.2 g/dL, p = 0.199. Conclusion:The prevalence of obstructive adenotonsillar hypertrophy was 55.3% in children and adolescents with sickle cell anemia; the presence of more than five episodes of tonsillitis in the last 12 months was associated with episodes of painful crises in the same period; there was no difference in the mean annual hemoglobin value among those with or without obstructive adenotonsillar hypertrophy. J Pediatr (Rio J). 2009;85(3):249-253:Tonsil, tonsillitis, hemoglobin, children, adolescents, sickle cell disease. ResumoObjetivos: Determinar a prevalência da hipertrofia adenotonsilar obstrutiva em crianças e adolescentes portadores de anemia falciforme; investigar possível associação entre presença de mais de cinco episódios de tonsilite nos últimos 12 meses e episódios de crise álgica no mesmo período; e comparar a hemoglobina anual média entre os que apresentam e os que não apresentam hipertrofia adenotonsilar obstrutiva.Métodos: Trata-se de estudo prospectivo, observacional do tipo corte transversal, com 85 crianças e adolescentes com anemia falciforme. Todos responderam questionário e avaliação otorrinolaringológica, incluindo endoscopia nasossinusal. Para o diagnóstico da hipertrofia adenotonsilar obstrutiva foram adotados os critérios de Brodsky.Resultados: A prevalência da hipertrofia adenotonsilar obstrutiva foi de 55,3%. A hipertrofia adenotonsilar obs...

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“…Esse fato tem sido confirmado por muitos autores 8,2 , enquanto outros não encontraram diferenças na prevalência entre os sexos 3,4 . Maior prevalência de SRO no sexo masculino pode decorrer da existência de vias aéreas inferiores mais estreitas e maior prevalência de rinite alérgica entre os meninos 22 .…”

Section: Discussionunclassified

“…Essa condição é denominada síndrome do respirador oral (SRO) quando mantida por um período igual ou maior que 6 meses. A SRO é frequente na infância, com prevalência variando de 26,6 a 53,3% das crianças em idade escolar no Brasil [1][2][3][4][5] .…”

Section: Introductionunclassified

Assessment of the body posture of mouth-breathing children and adolescents

Conti¹,

Sakano²,

Ribeiro³

et al. 2011

J Pediatr (Rio J)

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Objective: To investigate associations between mouth breathing (MBr), nose breathing (NBr) and body posture classification and clinical variables in children and adolescents, by comparing patients with mouth breathing syndrome with a control group of similar age. Methods:This was an observational, analytical, controlled, crosssectional study conducted at a university hospital. Children aged 5 years or more were recruited to one of two groups: healthy controls (NBr) or an MBr group. The MBr group comprised patients with a diagnosis of mouth breathing syndrome confirmed by clinical examination by a physician plus nasal endoscopy. The control group comprised healthy volunteers of the same age, with NBr confirmed by medical examination. All participants underwent postural assessment. Data were analyzed using the MannWhitney nonparametric test, the chi-square test and Fisher's exact test, to a significance level of 0.05%. Results:A total of 306 MBr and 124 NBr were enrolled. Mouth breathers were more likely to be male (p = 0.0002), have more frequent and more severe nasal obstruction and larger tonsils (p = 0.0001) than NBr. Mouth breathers also exhibited higher incidence rates of allergic rhinitis (p = 0.0001), of thoracic respiratory pattern (p = 0.0001), high-arched palate (p = 0.0001) and unfavorable postural classifications (p = 0.0001) with relation to the control group. Postural classification scores were directly proportional to nasal obstruction (p = 0.0001) and male sex (p = 0.0008).Conclusions: Postural problems were significantly more common among children in the group with mouth breathing syndrome, highlighting the need for early interdisciplinary treatment of this syndrome. J Pediatr (Rio J). 2011;87(4):357-363:Mouth breathing, child, adenoids, tonsils, rhinitis, prevalence. ResumoObjetivo: Verificar a associação do tipo respiratório oral (RO) e nasal (RN) e da classificação da postura corporal em variáveis clínicas de crianças e adolescentes com a síndrome do respirador oral, em relação a um grupo-controle de mesma faixa etária.Métodos: Estudo analítico do tipo observacional e transversal, com grupo-controle, realizado em hospital universitário. Foram incluídas crianças maiores de 5 anos, distribuídas em dois grupos: controle saudável (RN) e grupo RO. O grupo RO incluiu pacientes com diagnóstico de síndrome do respirador oral confirmado por exame clínico médico e nasofibroscopia. Participaram do grupo-controle voluntários saudá-veis da mesma faixa etária, cujo tipo RN foi confirmado por avaliação médica. Todos os participantes foram submetidos à avaliação postural. Para análise dos dados, foram utilizados os testes: não paramétrico de Mann-Whitney, qui-quadrado e exato de Fisher, considerando-se nível de significância de 0,05%. Artigo originAl 0021-7557/11/87- Não foram declarados conflitos de interesse associados à publicação deste artigo.Como citar este artigo: Conti PB, Sakano E, Ribeiro MA, Schivinski CI, Ribeiro JD. Assessment of the body posture of mouth-breathing children and adolescents.

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Etiology, clinical manifestations and concurrent findings in mouth-breathing children

Cited by 84 publications

References 14 publications

Development of craniofacial and dental arch morphology in relation to sleep disordered breathing from 4 to 12 years. Effects of adenotonsillar surgery

Development of craniofacial and dental arch morphology in relation to sleep disordered breathing from 4 to 12 years. Effects of adenotonsillar surgery

Association between adenotonsillar hypertrophy, tonsillitis and painful crises in sickle cell disease

Assessment of the body posture of mouth-breathing children and adolescents

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