Caracterização da pressão de lábios e língua em pacientes com apneia obstrutiva do sono
Data
2021
Autores
Ferreira, Amanda Santiago [UNIFESP]
Orientadores
Bommarito, Silvana [UNIFESP]
Tipo
Trabalho de conclusão de curso de graduação
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A Apneia Obstrutiva do Sono (AOS) é um distúrbio comum caracterizada pelo colapso repetitivo das vias aéreas da faringe durante o sono, sendo a principal estrutura colapsante a língua . Objetivo: Correlacionar a pressão de lábios e língua com a Apnéia Obstrutiva do Sono, segundo o índice de apnéia e hipopnéia, o índice facial, idade e dimorfismo sexual. Método: Trata-se de um estudo observacional e transversal. A amostra foi composta por 42 pacientes com idades entre 30 e 79 anos, (13 homens e 29 mulheres), diagnosticados com Apneia Obstrutiva do Sono (Grupo Pesquisa - GP). Um segundo grupo, denominado controle (GC) foi composto por 22 indivíduos saudáveis, com idades entre 17 e 37 anos, sem queixas relacionadas à deglutição e/ou fala. Os aspectos avaliados foram: tônus e mobilidade de lábios, língua e bochechas, índice de Mallampati, medidas antropométricas e prosopométricas. A avaliação objetiva da pressão dos lábios e da língua foi realizada por meio do aparelho PLL Pró-Fono (BIOFEEDBACK: PRESSÃO DE LÁBIOS E DE LÍNGUA), durante as provas de pressão dos lábios, protrusão da ponta da língua, elevação do dorso da língua contra o palato. Resultados: Ao compararmos a pressão da ponta da língua, dorso da língua e pressão dos lábios obtidos do grupo AOS e do grupo saudável encontramos diferenças estatisticamente significantes quanto a pressão de dorso de língua (p=0,002) e de lábios (p=0,20). Verificamos que a média do Índice de Massa Corporal foi 28,57 e do Índice de Apnéia e Hipopnéia foi 18,52, em indivíduos do GP. Ao compararmos a circunferência cervical e circunferência abdominal em função do sexo em indivíduos com AOS verificamos que a circunferência abdominal dos homens foi significativamente maior que das mulheres (p=0,001). Houve frequência significativamente maior de mobilidade de língua (82,93%) e bochechas (80,49%) adequadas. Quanto à análise do tipo facial encontramos 61% dos pacientes euriprósopos, seguido do tipo facial mesoprósopo (24,40%) e do leptoprósopo (14,60%), respectivamente. Os pacientes com mobilidade de língua adequada apresentaram maiores valores de pressão na ponta de língua, que os com mobilidade de língua diminuída (p=0,033). Conclusão: Pacientes com AOS apresentam menor pressão de dorso de língua comparados com indivíduos sem AOS. Houve correlação entre o IAH e a circunferência abdominal, indicando assim sobrepeso como um fator de risco para a Apnéia Obstrutiva do Sono. Não houve correlação entre a pressão da língua e a circunferência cervical e abdominal, segundo a idade e sexo. O tipo facial leptoprósopo apresentou maior pressão de ponta e dorso de língua que os tipos euriprósopo e mesoprosopo.
Objective: Correlate the pressure of lips and tongue with the Obstructive Sleep Apnea (OSA), according to the apnea and hypopnea index, the facial index, age and sexual dimorphism. Method: This is an observational and cross-sectional study. The study was approved by the institutional CEP under protocol number: 573,179. The sample consisted of a convenience group, including 42 individuals aged between 30 and 79 years, (13 men and 29 women), patients diagnosed with Obstructive Sleep Apnea (Research Group - RG). A second group, called control (CG) was composed of 22 healthy individuals, aged between 17 and 37 years, without complaints related to swallowing and/or speech. The aspects evaluated were: tonus and mobility of lips, tongue and cheeks, Mallampati index, anthropometric and prosopometric measurements. The evaluation of the pressure of the lips and tongue was performed using the PLL Pró-Fono device (BIOFEEDBACK: LIPS AND TONGUE PRESSURE), during the tests of lip pressure, tongue tip protrusion, tongue dorsum elevation against the palate. Results: When comparing the pressure of the tip of the tongue, dorsum of the tongue and pressure of the lips obtained from the OSA group and the healthy group, we found statistically significant differences regarding the pressure of the dorsum of the tongue (p=0.002) and of the lips (p=0.20). We verified that the mean of the Body Mass Index was 28.57 and of the Apnea and Hypopnea Index was 18.52, in individuals from the RG. When comparing cervical circumference and waist circumference as a function of sex in individuals with OSA, we found that the waist circumference of men was significantly greater than that of women (p=0.001). There was a significantly higher frequency of adequate tongue mobility (82.93%) and adequate cheeks (80.49%). As for the analysis of the facial type, we found 61% of euryprosop patients, followed by the mesoprosop facial type (24.40%) and the leptoprosop (14.60%), respectively. Patients with adequate tongue mobility had higher pressure values at the tip of the tongue than those with reduced tongue mobility (p=0.033). Based on the results of this study, we could conclude that patients with OSA have lower pressure on the dorsum of the tongue compared to individuals without OSA. There was a correlation between the AHI and waist circumference, thus indicating overweight as a risk factor for Obstructive Sleep Apnea. There was no correlation between tongue pressure and cervical and abdominal circumference, according to age and sex. The leptoprosop facial type presented greater tongue tip and dorsum pressure than the euryprosop and mesoprosop types.
Objective: Correlate the pressure of lips and tongue with the Obstructive Sleep Apnea (OSA), according to the apnea and hypopnea index, the facial index, age and sexual dimorphism. Method: This is an observational and cross-sectional study. The study was approved by the institutional CEP under protocol number: 573,179. The sample consisted of a convenience group, including 42 individuals aged between 30 and 79 years, (13 men and 29 women), patients diagnosed with Obstructive Sleep Apnea (Research Group - RG). A second group, called control (CG) was composed of 22 healthy individuals, aged between 17 and 37 years, without complaints related to swallowing and/or speech. The aspects evaluated were: tonus and mobility of lips, tongue and cheeks, Mallampati index, anthropometric and prosopometric measurements. The evaluation of the pressure of the lips and tongue was performed using the PLL Pró-Fono device (BIOFEEDBACK: LIPS AND TONGUE PRESSURE), during the tests of lip pressure, tongue tip protrusion, tongue dorsum elevation against the palate. Results: When comparing the pressure of the tip of the tongue, dorsum of the tongue and pressure of the lips obtained from the OSA group and the healthy group, we found statistically significant differences regarding the pressure of the dorsum of the tongue (p=0.002) and of the lips (p=0.20). We verified that the mean of the Body Mass Index was 28.57 and of the Apnea and Hypopnea Index was 18.52, in individuals from the RG. When comparing cervical circumference and waist circumference as a function of sex in individuals with OSA, we found that the waist circumference of men was significantly greater than that of women (p=0.001). There was a significantly higher frequency of adequate tongue mobility (82.93%) and adequate cheeks (80.49%). As for the analysis of the facial type, we found 61% of euryprosop patients, followed by the mesoprosop facial type (24.40%) and the leptoprosop (14.60%), respectively. Patients with adequate tongue mobility had higher pressure values at the tip of the tongue than those with reduced tongue mobility (p=0.033). Based on the results of this study, we could conclude that patients with OSA have lower pressure on the dorsum of the tongue compared to individuals without OSA. There was a correlation between the AHI and waist circumference, thus indicating overweight as a risk factor for Obstructive Sleep Apnea. There was no correlation between tongue pressure and cervical and abdominal circumference, according to age and sex. The leptoprosop facial type presented greater tongue tip and dorsum pressure than the euryprosop and mesoprosop types.