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Abstract(s)
A respiração oral instaura-se de forma crónica geralmente como resultado de uma obstrução ao nível das vias aéreas superiores ou de um hábito adquirido.
As causas de obstrução mais comuns são rinite alérgica, hipertrofia adenoamigdalina,
desvios do septo e colapso nasal inspiratório.
O prolongamento da respiração oral para uma situação crónica em idades infantis pode
ter repercussões a diversos níveis na criança, sistémicos, cognitivos e estruturais.
O desconhecimento das repercussões e dos prováveis fatores de risco desta síndrome,
leva muitas vezes ao seu negligenciamento por parte dos pais da criança.
As alterações posturais inerentes da criança respiradora oral, geram um desequilíbrio nas forças intraorais, manifestando-se consequentemente em má-oclusões, alterações do desenvolvimento das estruturas craniofaciais e transformações posturais não só das
estruturas diretamente envolvidas da cabeça e do pescoço, mas do organismo como um
todo. As alterações provocadas pela falha no acondicionamento nasal do ar inspirado,
assumem repercussões sistémicas tais como, maior propensão para infeções do trato
respiratório, diminuição da resistência física da criança e até repercussões orais, com uma maior predisposição para processos inflamatórios e infeciosos.
A qualidade do sono também parece alterada nestas crianças. Uma forte associação tem sido feita entre esta síndrome e os principais distúrbios respiratórios do sono, como a apneia obstrutiva. Esta perturbação leva a uma fragmentação excessiva do sono, com
manifestações nefastas nos níveis de crescimento físico e desenvolvimento cognitivo.
Estudos têm revelado uma maior prevalência de subaproveitamento escolar em crianças
respiradoras orais.
O tardamento no tratamento desta síndrome deve a todo o custo ser evitado. Quanto mais tardio, mais graves e prevalentes parecem ser os efeitos desta síndrome na criança. Para tal, uma abordagem multidisciplinar é sugerida entre o otorrinolaringologista, ortodontista e terapeuta da fala, enfatizando a importância na prevenção e acima de tudo, um diagnóstico precoce.
Oral breathing can usually be established as the result of an upper airway obstruction or an acquired habit. The most common causes of obstruction are allergic rhinitis, adenotonsillar hypertrophy, obstructive septum deviations and inspiratory nasal collapse. The maintenance of this breathing pattern to a chronic situation in early ages, may have repercussions on different levels in children: systemic, cognitive and structural. The unawareness of the repercussions and risk factors of this syndrome, often leads to its neglect by the child’s parents. The postural changes inherent to oral breathing, generate an imbalance of the intraoral forces, that consequently manifests in malocclusions, alterations in the development of craniofacial structures and postural abnormalities. Not only the head and neck region is affected, but the whole body and its postural axis. The alterations caused by the failure in the inspired air conditioning, assume systemic repercussions, such as, greater propensity to respiratory tract infections, decreased physical resistance and even, oral manifestations, with an higher prone to inflammatory and infectious processes. The quality of sleep also seems disturbed in these children. A strong association has been established between oral breathing and obstructive sleep-disordered breathing, such as obstructive sleep apnea. This disturbance leads to excessive fragmentation of sleep, with harmful comorbilities in the child’s growing process and physic and cognitive development. Studies have revealed a higher prevalence of poor academic performance in oral breathing children. The delay of treatment of the obstruction cause must at all cost be avoided. The later the treatment, the more severe and prevalent appear to be the consequences of oral breathing. A multidisciplinary approach is recommended between the otorhinolaryngologist, orthodontist and the speech therapist, emphasizing the importance in prevention and above all, an early diagnosis.
Oral breathing can usually be established as the result of an upper airway obstruction or an acquired habit. The most common causes of obstruction are allergic rhinitis, adenotonsillar hypertrophy, obstructive septum deviations and inspiratory nasal collapse. The maintenance of this breathing pattern to a chronic situation in early ages, may have repercussions on different levels in children: systemic, cognitive and structural. The unawareness of the repercussions and risk factors of this syndrome, often leads to its neglect by the child’s parents. The postural changes inherent to oral breathing, generate an imbalance of the intraoral forces, that consequently manifests in malocclusions, alterations in the development of craniofacial structures and postural abnormalities. Not only the head and neck region is affected, but the whole body and its postural axis. The alterations caused by the failure in the inspired air conditioning, assume systemic repercussions, such as, greater propensity to respiratory tract infections, decreased physical resistance and even, oral manifestations, with an higher prone to inflammatory and infectious processes. The quality of sleep also seems disturbed in these children. A strong association has been established between oral breathing and obstructive sleep-disordered breathing, such as obstructive sleep apnea. This disturbance leads to excessive fragmentation of sleep, with harmful comorbilities in the child’s growing process and physic and cognitive development. Studies have revealed a higher prevalence of poor academic performance in oral breathing children. The delay of treatment of the obstruction cause must at all cost be avoided. The later the treatment, the more severe and prevalent appear to be the consequences of oral breathing. A multidisciplinary approach is recommended between the otorhinolaryngologist, orthodontist and the speech therapist, emphasizing the importance in prevention and above all, an early diagnosis.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Respiração oral Repercussões Crescimento Pediatria