Abstract
ABSTRACT Objective: to evaluate the speech sound production of children diagnosed with a palatine mouth breathing and / or hypertrophic pharyngeal tonsil and compare it to that of a group of children that do not show any respiratory alterations, besides associating with age and sex. Methods: a quantitative, cross-sectional, analytical and observational research. Children from five to twelve years old have took part of the study, 50 of them diagnosed as mouth breathers (research group - RG) and 50 with no respiratory alteration (control group - CG). Anamnesis and evaluation based on MBGR protocol was performed, focusing on the speech, supported by figures and with samples of automatic and spontaneous speech. Results: there were no differences between the groups, taking into account the parents' complaint. Speech alterations, such as phonetic deflection, lingual interposition and distortions, and occlusion alterations were more frequent in RG. Speech alterations prevailed for males in 83% and the average age related to speech did not show any significance. Conclusion: mouth breathing children present more alterations of speech sounds than those presented with no respiratory alteration, regardless of the age group, being more common in male children.
Highlights
Proper breathing is established by nasal airways up to the lungs, providing individuals with upper airways protection for their craniofacial growth and development, in addition to the maintenance of the normal performance of their stomatognathic functions[1]
The assessed children were in a waiting list for the surgical procedure of removing the hypertrophic tonsils and/or adenoids, being referred to that waiting list after otorhinolaryngological assessment, clinical exam, mouth testing to screen the degree of palatine tonsils hyperplasia, evaluating recurrent tonsillitis, acute tonsillitis, tonsil stone, cavum radiograph, and assessment by using flexible nasal fibro-endoscope (3mm) for rhinopharyngeal screening, and oropharyngeal screening for upper pole hyperplasia of the palatine tonsils
As for the anamnesis data, it can be observed that most legal guardians from both groups do not report any current difficulties and/or delay in speech acquisition on the part of the children (CG = 14%; Research Group (RG) = 18%; p = 0.585)
Summary
Proper breathing is established by nasal airways up to the lungs, providing individuals with upper airways protection for their craniofacial growth and development, in addition to the maintenance of the normal performance of their stomatognathic functions[1]. The exchange of nasal respiratory mode for oral one is quite common in the first years of life due to interfering factors[4], such as organic changes: obstruction of the upper airways (rinitis[5], hypertrophic palatine and/ or pharyngeal tonsils, deviation of septum, among others), or even non-organic changes, due to deleterious habits[2,6]. In the orofacial motricity[7], the degree of impairment is related to the time length and chronicity of the respiratory alteration[8], causing several changes in individuals’ lives, such as craniofacial modifications, sleep disorders, functional changes in the stomatognathic system and in the phono-articulatory organs[9]. Adenotonsillectomy, in order to remove hypertrophic palatine and pharyngeal tonsils, is the most performed surgical procedure in the world, and the commonest otorhinolaryngological surgery[10]. Surgery is recommended in case of chronic inflammation of those structures[11 ]
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