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Nasal patency and otorhinolaryngologic-orofacial features in children
Jovana de Moura Milanesi1, Luana Cristina Berwig1, Luiz Henrique Schuch2
1Universidade Federal de Santa Maria, Programa de Distúrbios de Comunicação Humana, Santa Maria, RS, Brazil.
Insights
Children with nasal obstruction, often linked to rhinitis, exhibit reduced nasal patency. This study highlights connections between nasal patency and various orofacial and sleep characteristics in children.
Area of Science:
- Pediatric Otolaryngology
- Speech-Language Pathology
- Pediatric Pulmonology
Background:
- Nasal obstruction is a frequent childhood issue, often associated with rhinitis and enlarged pharyngeal tonsils.
- This can lead to mouth breathing, potentially causing orofacial and otorhinolaryngologic changes.
- Objective assessment of upper airway function can be achieved through nasal patency measurements.
Purpose of the Study:
- To compare nasal patency with otorhinolaryngologic-orofacial features in children.
- To investigate the relationship between nasal patency and symptoms like restless sleep and mouth breathing.
Main Methods:
- Evaluated 123 children aged 6-12 years using speech therapy assessments (Orofacial Myofunctional Evaluation protocol).
- Conducted clinical and endoscopic otorhinolaryngologic examinations.
- Measured nasal patency using absolute and predicted peak nasal inspiratory flow (PNIF) values.
Main Results:
- Lower PNIF values were observed in children with restless sleep, reported nasal obstruction, runny nose, and altered chewing or swallowing.
- Reduced absolute PNIF correlated with a pale inferior turbinate, narrow hard palate, and speech changes.
- Increased tongue width and mild everted lips were associated with higher absolute and predicted PNIF.
Conclusions:
- Nasal patency is diminished in children experiencing restless sleep, rhinitis symptoms, reduced hard palate width, and functional changes in mastication, deglutition, and speech.
- A significant proportion of the studied children exhibited signs and symptoms indicative of allergic rhinitis.
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.
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