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Respiração oral : implicações na estrutura crânio facial e na qualidade de vida
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A respiração oral é um sintoma frequente especialmente nas crianças, e que na grande maioria das vezes é subvalorizado e subdiagnosticado. Existem várias causas que podem induzir esta alteração no padrão respiratório, sendo as mais frequentes a hipertrofia adenoideia na infância e o desvio do septo e a hipertrofia dos cornetos no adulto.
Por definição, o respirador oral é o individuo que respira predominantemente pela boca, por um período de, pelo menos, 6 meses. Quando esta situação ocorre na infância a conformação crânio facial fica alterada e é reconhecido clinicamente na perspectiva da ORL como o fácies adenoideu.
O crescimento facial tem paralelismo com o do resto do corpo e caracteriza-se pelo desenvolvimento dos óssos e tecidos moles constituintes, tendo os tecidos moles um importante papel como matriz. O desenvolvimento craniofacial, além dos estímulos genotípicos, é modulado por estímulos epigenéticos dos quais faz parte a respiração. Por este motivo, qualquer alteração no padrão respiratório terá impacto no desenvolvimento craniofacial, sendo que as alterações surgem como uma adaptação do corpo de forma a facilitar a passagem de ar pela boca e orofaringe. Este crescimento determina também os diferentes biótipos que se podem observar na população e que têm influência na relação maxilomandibular podendo predispor a má-oclusões dentárias. No seu conjunto, estas alterações terão um grande impacto da qualidade de vida do individuo afectando por exemplo a alimentação, o sono, a aprendizagem e a capacidade física. Além do desenvolvimento craniofacial, a respiração oral tem também consequências na postura corporal.
Mouth breathing is a common symptom, especially among children, and in most cases it is undervalued and underdiagnosed. There are several causes that can induce this change in the breathing pattern, the most frequent being adenoid hypertrophy in childhood and deviation of the septum and hypertrophy of the turbinates in adults. By definition, the mouth breather is the individual who breathes predominantly through the mouth, for a period of at least 6 months. When this situation occurs in childhood, the craniofacial conformation is altered and is clinically recognized in the ENT perspective as the adenoid facies. Facial growth parallels that of the rest of the body and is characterized by the development of its bones and soft tissues around them, with soft tissues having an important role as a developmental matrix. In addition to genotypic stimuli, craniofacial development is modulated by epigenetic stimuli of which breathing is a part. For this reason, any change in the breathing pattern will have an impact on craniofacial development, and the changes appear as an adaptation of the body in order to facilitate the passage of air through the mouth and oropharynx. This growth also determines the different biotypes that can be observed in the population and that have an influence on the maxillomandibular relationship and may predispose to dental malocclusions. Taken as a whole, these changes will have a great impact on the individual's quality of life, affecting, for example, food, sleep, learning and physical capacity. In addition to craniofacial development, mouth breathing also has consequences for body posture.
Mouth breathing is a common symptom, especially among children, and in most cases it is undervalued and underdiagnosed. There are several causes that can induce this change in the breathing pattern, the most frequent being adenoid hypertrophy in childhood and deviation of the septum and hypertrophy of the turbinates in adults. By definition, the mouth breather is the individual who breathes predominantly through the mouth, for a period of at least 6 months. When this situation occurs in childhood, the craniofacial conformation is altered and is clinically recognized in the ENT perspective as the adenoid facies. Facial growth parallels that of the rest of the body and is characterized by the development of its bones and soft tissues around them, with soft tissues having an important role as a developmental matrix. In addition to genotypic stimuli, craniofacial development is modulated by epigenetic stimuli of which breathing is a part. For this reason, any change in the breathing pattern will have an impact on craniofacial development, and the changes appear as an adaptation of the body in order to facilitate the passage of air through the mouth and oropharynx. This growth also determines the different biotypes that can be observed in the population and that have an influence on the maxillomandibular relationship and may predispose to dental malocclusions. Taken as a whole, these changes will have a great impact on the individual's quality of life, affecting, for example, food, sleep, learning and physical capacity. In addition to craniofacial development, mouth breathing also has consequences for body posture.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020
Palavras-chave
Respiração oral Desenvolvimento Sono Alimentação Aprendizagem Otorrinolaringologia