Estudo clínico multidisciplinar comparativo entre crianças respiradoras orais e nasais
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Data
2013
Autores
Sakai, Andrea Peiyun Chi [UNIFESP]
Orientadores
Pignatari, Shirley Shizue Nagata [UNIFESP]
Tipo
Dissertação de mestrado
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Objetivo: Comparar os achados da avaliacao clinica de criancas respiradoras orais versus criancas respiradoras nasais por medicos otorrinolaringologista e alergologista, fonoaudiologo, fisioterapeuta, odonto-pediatra e ortodontista. Metodo: A primeira parte retrospectiva, pela analise de prontuario de 104 criancas respiradoras orais atendidas pelos especialistas de 2009 a 2011 no Centro do Respirador Oral da UNIFESP; a segunda parte prospectiva pela avaliacao clinica de 33 criancas respiradoras nasais pelos mesmos profissionais, com comparacao estatistica dos resultados encontrados pelo Teste de Igualdade de duas proporcoes. Resultados: Entre os grupos nao houve diferenca em relacao ao sexo, idade, queixas irritativas nasais, dificuldades na alimentacao, mau rendimento escolar, positividade no prick test, presenca de caries, distribuicao de tipo facial, atresia maxilar, tipo de aleitamento, tonus de labios inferiores, mobilidade de labios, problemas na mastigacao, postura de cabeca (vista lateral), coluna lombar, joelhos e pelve. Houve diferenca estatisticamente significante nas queixas de roncos noturnos, apneia testemunhada, sono agitado, sialorreia, presenca de gengivite, alteracoes oclusais, postura de labios e tonus de labios superiores, postura de lingua, tonus e mobilidade de lingua, postura de cabeca (vista anterior), postura de ombros (vistas anterior e lateral), coluna cervical e dorsal e pes. No grupo de respiradores orais, somente as incidencias de gengivite e alteracoes oclusais (representada pela mordida aberta) foram menores em relacao aos respiradores nasais; o restante das alteracoes foi mais frequente entre o primeiro grupo. Conclusoes: As criancas respiradoras orais avaliadas no estudo apresentaram maior comprometimento que as criancas respiradoras nasais em relacao aos sistemas fono-articulatorio e estomatognatico, apesar da ausencia de repercussao no processo da mastigacao, e posturais. Nao houve diferenca significativa de presenca de atresia maxilar ou distribuicao de tipo facial entre os grupos, e a mordida cruzada anterior foi mais encontrada em respiradores nasais que em orais. E fundamental o conhecimento das possiveis repercussoes locais e sistemicas da respiracao oral, para que o tratamento possa ser instituido de forma precoce e preferencialmente multidisciplinar. Outra questao importante e a necessidade de definir o conceito de respirador oral, medida que, alem de facilitar a conducao terapeutica dos casos, contribuiria para padronizar as pesquisas sobre o tema.
Objective: To compare the findings of the clinical evaluation of mouth breathing children versus nasal breathing children by otolaryngologist, allergist, audiologist, physiotherapist, pediatric dentist and orthodontist. Method: The first part was a retrospective an alysis of the medical records of 104 mouth breathing children assisted by specialists from 2009 to 2011 in Mouth Breather Center of UNIFESP and the second part was a prospective clinical evaluation of 33 children nasal breathing by the same professionals, with statistical comparison of the results. Results: Among the groups did not differ in relation to sex, age, irritating nasal complaints, feeding difficulties, poor school performance, prick test positivity, presence of dental caries, distribution of facial type, maxillary atresia, type of feeding, tone of lower lips, lip mobility, problems with chewing, head posture (side view), lumbar spine, pelvis and knees. There was a statistically significant difference in complaints of snoring, witnessed apnea, restless sleep, drooling, presence of gingivitis, dental occlusal changes, posture and tone of lips, tone of upper lips, tongue posture, tongue tone and mobility, head posture (anterior view ), posture of shoulders (anterior and lateral views), dorsal and cervical spine and feet. In the group of mouth breathers, only the incidence of gingivitis and occlusal changes (represented by open bite) were smaller compared to nasal breathing, the rest of the changes were more frequent in the first group. Conclusions: The mouth breathing children evaluated in the study showed greater impairment than nasal breathing children in relation to phono-articulatory and stomatognathic systems, despite the lack of impact in the process of chewing, and posture. There was no significant difference in the presence of maxillary atresia or distribution of facial type between groups, and anterior crossbite was found more in nasal than in oral breathers. It is important to know the possible local and systemic effects of mouth breathing, so that treatment can be instituted early and preferably multidisciplinary. Another important issue is the need to define the concept of a mouth breather to facilitate the therapeutic management of cases and the research of the topic.
Objective: To compare the findings of the clinical evaluation of mouth breathing children versus nasal breathing children by otolaryngologist, allergist, audiologist, physiotherapist, pediatric dentist and orthodontist. Method: The first part was a retrospective an alysis of the medical records of 104 mouth breathing children assisted by specialists from 2009 to 2011 in Mouth Breather Center of UNIFESP and the second part was a prospective clinical evaluation of 33 children nasal breathing by the same professionals, with statistical comparison of the results. Results: Among the groups did not differ in relation to sex, age, irritating nasal complaints, feeding difficulties, poor school performance, prick test positivity, presence of dental caries, distribution of facial type, maxillary atresia, type of feeding, tone of lower lips, lip mobility, problems with chewing, head posture (side view), lumbar spine, pelvis and knees. There was a statistically significant difference in complaints of snoring, witnessed apnea, restless sleep, drooling, presence of gingivitis, dental occlusal changes, posture and tone of lips, tone of upper lips, tongue posture, tongue tone and mobility, head posture (anterior view ), posture of shoulders (anterior and lateral views), dorsal and cervical spine and feet. In the group of mouth breathers, only the incidence of gingivitis and occlusal changes (represented by open bite) were smaller compared to nasal breathing, the rest of the changes were more frequent in the first group. Conclusions: The mouth breathing children evaluated in the study showed greater impairment than nasal breathing children in relation to phono-articulatory and stomatognathic systems, despite the lack of impact in the process of chewing, and posture. There was no significant difference in the presence of maxillary atresia or distribution of facial type between groups, and anterior crossbite was found more in nasal than in oral breathers. It is important to know the possible local and systemic effects of mouth breathing, so that treatment can be instituted early and preferably multidisciplinary. Another important issue is the need to define the concept of a mouth breather to facilitate the therapeutic management of cases and the research of the topic.
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SAKAI, Andrea Peiyun Chi. Estudo clínico multidisciplinar comparativo entre crianças respiradoras orais e nasais. 2013. 69 f. Dissertação (Mestrado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2013.