Upper Airway Obstruction in Children: Prevalence, Diagnosis, Repercussions, and Comorbidities

Abstract

Objectives: Investigate the prevalence, diagnosis, and repercussions of upper airway obstruction in children under 5 years-old and their impact in public health. Methods: A cross-sectional study was conducted with 197 children under 5, randomly selected from a population of 1500, from November 2011 to December 2012. Parents answered to anamnesis about respiratory problems, upper airway infections, perinatal history, and feeding habits. They answered validated questionnaires about sleep disordered breathing and allergies. All subjects underwent a physical examination, and those who complained of respiratory problems also had nasal fiberendoscopy. Results: 197 subjects (2.33 ± 1.09 y.o.), 107 boys. Prevalence of mouth breathing was 19.2%, nasal obstruction 18.2%, snoring 22.8%, rhinorrhea and sneezing 36.5%, and sleep disordered breathing (SDB) 7.1%. Diagnosis: adenoid enlargement (A) 8.6%, tonsil enlargement (T) 0.5%, tonsil and adenoid enlargement (T&A) 10.7%, rhinitis 21.9%, allergic rhinitis 7.6% (totalizing 49.6%). Fifty-five point seven percent of children were exclusively breast fed for at least 6 months, and no correlation was found with nasal obstruction. Sleep disordered breathing symptoms were found in 7.1 % and were associated only with T&A (64.2%). Children with upper airway obstruction were prone to upper airway infections and visits to the emergency room. Conclusions: Upper airway obstruction is prevalent in about 20% of children. Breast feeding was not correlated to mouth breathing. Rhinitis is a common diagnosis. T&A is associated with SDB and infections, consuming high resources. Doctors must investigate and refer young children with upper airway problems to treatment in order to minimize large consumption of health resources.