Rodrigo Agne Ritzel

Análise quantitativa do palato duro em diferentes tipologias faciais de respiradores nasais e orais

PURPOSE: to compare the hard palate dimensions in nasal and mouth breathing children of different facial typologies. METHOD: the sample comprised 54 children between seven and 11 year old, divided in two groups according to the facial type and breathing mode. The facial type was obtained through the Ricketts cephalometric analysis, and the breathing mode was determined from speech-language evaluation and otorhynolaryngologic diagnosis. In order to measure the transverse, vertical and anteroposterior length of the hard palate, plaster cast models of the children superior dental arch were obtained. To get the hard palate dimensions among the groups, parametric and nonparametric tests were used under a significance level of 5%. RESULTS: no statistically significant difference was found in hard palate measures among brachyfacial, mesofacial and dolichofacial children. A significant statistical difference in the distance among the second premolars was identified when compared with the different facial types of nasal and mouth breathing children, and such a difference was not detected in multiple comparisons. CONCLUSION: the dimensions of the hard palate did not show any difference when analyzed in different facial types regardless of the breathing mode. However, when analyzing the facial type in nasal and mouth breathers, we found a difference in the distance among the second premolars.

Childhood mouth-breathing consequences at adult age: ventilatory function and quality of life

Introduction Mouth breathing can affect the functions of the respiratory systems and quality of life. For this reason, children who grow up with this stimulus may have implications on physical and psychological aspects at adult age.Objective To evaluate childhood mouth-breathing consequences for the ventilatory function and quality of life at adult age.Materials and methods Prospective, observational and cross-sectional study with 24 adults, between 18 and 30 years old, mouth breathers during childhood, comprised the childhood mouth-breathing group (CMB). The childhood nasal-breathing (CNB) group was composed of 20 adults of the same age, without history of respiratory disease during all their lives. Measurements of maximal respiratory pressures, peak expiratory flow and 6-minute walk test were assessed. In addition, all the volunteers answered the Short Form-36 questionnaire (SF-36).Results The maximal inspiratory (p = 0.001) and expiratory (p = 0.000) pressures as well as the distance in the walk test (p = 0.003) were lower in the COB. The COB also presented lower score in the General Health domain of the SF-36 Questionnaire (p = 0.002).Conclusion Childhood mouth-breathing yields consequences for the ventilatory function at adult age, with lower respiratory muscle strength and functional exercise capacity. Conversely, the quality of life was little affected by the mouth breathing in this study.

Correlation between nasopharyngoscopy and cephalometry in the diagnosis of hyperplasia of the pharyngeal tonsils

Summary Introduction: Hyperplasia of the pharyngeal tonsil is one of the main causes of mouth breathing, and accurate diagnosis of this alteration is important for proper therapeutic planning. Therefore, studies have been conducted in order to provide information regarding the procedures that can be used for the diagnosis of pharyngeal obstruction. Objective: To verify the correlation between nasopharyngoscopy and cephalometric examinations in the diagnosis of pharyngeal tonsil hyperplasia. Method: This was a cross-sectional, clinical, experimental, and quantitative study. Fifty-five children took part in this study, 30 girls and 25 boys, aged between 7 and 11 years. The children underwent nasofibropharyngoscopic and cephalometric evaluation to determine the grade of nasopharyngeal obstruction. The Spearmans rank correlation coefficient at the 5% significance level was used to verify the correlation between these exams. Results: In the nasopharyngoscopy evaluation, most children showed grade 2 and 3 hyperplasia of the pharyngeal tonsil, which was followed by grade 1. In the cephalometry assessment, most children showed grade 1 hyperplasia of the pharyngeal tonsil, which was followed by grade 2. A statistically significant regular positive correlation was observed between the exams. Conclusion: It was concluded that the evaluation of the pharyngeal tonsil hyperplasia could be carried out by fiber optic nasopharyngoscopy and cephalometry, as these examinations were regularly correlated. However, it was found that cephalometry tended to underestimate the size of the pharyngeal tonsil relative to nasopharyngoscopy.

Nasal patency and otorhinolaryngologic-orofacial features in children

INTRODUCTION Nasal obstruction is a common symptom in childhood, related to rhinitis and pharyngeal tonsil hypertrophy. In the presence of nasal obstruction, nasal patency may be reduced, and nasal breathing is replaced by mouth breathing. Orofacial and otorhinolaryngologic changes are related to this breathing mode. Objective evaluation of upper airways may be obtained through nasal patency measurement. OBJECTIVE To compare nasal patency and otorhinolaryngologic-orofacial features in children. METHODS One hundred and twenty three children, 6-12 year-old, and of both sexes underwent speech therapy evaluation, according to Orofacial Myofunctional Evaluation protocol, clinical and endoscopic otorhinolaryngologic examination and nasal patency measurement, using the absolute and predicted (%) peak nasal inspiratory flow values. RESULTS Lower values of absolute and estimated peak nasal inspiratory flow values were found in children with restless sleep (p=0.006 and p=0.002), nasal obstruction report (p=0.027 and p=0.023), runny nose (p=0.004 and p=0.012), unsystematic lip closure during mastication (p=0.040 and p=0.026), masticatory speed reduced (p=0.006 and p=0.008) and altered solid food swallowing (p=0.006 and p=0.001). Absolute peak nasal inspiratory flow was lower in children with pale inferior turbinate (p=0.040), reduced hard palate width (p=0.037) and altered speech (p=0.004). Higher absolute values were found in children with increased tongue width (p=0.027) and, higher absolute and predicted (%) in children with mild everted lip (p=0.008 and p=0.000). CONCLUSIONS Nasal patency was lower in children with restless sleep, rhinitis signs and symptoms, hard palate width reduced and with changes in mastication, deglutition and speech functions. It is also emphasized that most of the children presented signs and symptom of allergic rhinitis.