Effects of lingual frenotomy on breastfeeding and electrical activity of the masseter and suprahyoid muscles.

PURPOSE: To analyze the effects of lingual frenotomy on the breastfeeding of infants, based on the electrical activity of the masseter and suprahyoid muscles and assessment of the breastfeeding. METHODS: Observational study developed between October 2017 and June 2018 with a sample of 20 newborns and infants who attended a dental clinic and were diagnosed with ankyloglossia. Another 20 were excluded for meeting some of the following exclusion criteria: babies more than 6 months old, who were not on exclusive or mixed breastfeeding, who had other clinical impairments that interfered with breastfeeding, who had other foods introduced into their diet, who had neurological changes and/or craniofacial deformities, and/or who did not finish all the stages of the study. Breastfeeding was assessed with the UNICEF Breastfeeding Assessment and Observation Protocol, while the muscle electrical activity was assessed with the Electrical Activity Assessment Protocol for the Masseter and Suprahyoid Muscles in Newborns During Breastfeeding. The same speech-language-hearing therapist conducted the two assessments both before the conventional frenotomy and 7 days after it. RESULTS: The signs suggestive of breastfeeding difficulties changed 7 days after the surgery, with a p-value ≤ 0.002 for general observation of the mother, position of the infant, latch, and sucking. The maximum voluntary contraction of the masseter was the only integral parameter with a difference, as the electrical activity had decreased. CONCLUSION: Behaviors favorable to breastfeeding increased 7 days after the frenotomy in all the breastfeeding assessment categories, whereas the electrical activity of the masseter decreased.

Relationship between microcephaly and indicators of social inequality in the state of Paraíba, Brazil.

OBJECTIVE: • Seventy-four (33.18%) municipalities in the state of Paraíba registered live births with microcephaly. • The highest proportion of cases (23.03%) was concentrated in the capital, João Pessoa. • Number of inhabitants, number of cases of Zika virus, water supply, and average household income were associated with a higher proportion of new cases. To analyze the relationship between microcephaly and social inequality indicators in the state of Paraíba during the biennium January 2015 and December 2016. METHODS: Ecological study with data from newborn microcephaly records and municipal socioeconomic, environmental, and demographic indicators was conducted using two health information systems from the Brazilian Ministry of Health (SINASC and SINAN) and the Brazilian Institute of Geography and Statistics. A Poisson multiple regression model was applied with a significance level of 5%. RESULTS: Among 223 municipalities in Paraíba, 74 registered new cases of microcephaly. The number of Zika virus cases, number of inhabitants, number of households without adequate water supply, and household income were predictor variables of the number of new cases of microcephaly in Paraíba. CONCLUSION: Microcephaly is associated with indicators of social inequality in Paraíba. Zika virus cases, water supply, and family income are the indicators that best explain the increase in microcephaly cases. Therefore, these variables must be monitored by health professionals and authorities.

Patência nasal em crianças respiradoras orais / Nasal patency in mouth breathing children

RESUMO Vários estudos mostram a importância da avaliação quantitativa na patência nasal e do estado funcional das vias aéreas superiores para fornecer informações clínicas e diagnósticas em indivíduos respiradores orais, as quais são de grande interesse para a fonoaudiologia. O objetivo deste estudo foi avaliar o efeito da irrigação de solução salina nasal nas vias aéreas superiores através da aeração nasal e rinomanometria anterior ativa em crianças respiradoras orais. Estudo de série de oito casos, realizado em crianças com idades entre 7 e 10 anos, com diagnóstico clínico otorrinolaringológico de respiração oral. O estudo consistiu em três etapas: avaliação inicial; intervenção e avaliação final. Foram aplicados os questionários do Índice de Identificação dos Sinais e Sintomas da Respiração Oral e qualidade de vida específica para doenças em pacientes pediátricos com queixas sinonasais. Realizaram-se as avaliações da aeração nasal e o exame da rinomanometria anterior ativa. A intervenção foi realizada por meio da irrigação de solução salina nasal com 10 ml. Em seguida, os pacientes foram reavaliados pela avaliação da aeração nasal e rinomanometria, para comparar os resultados. Em relação à avaliação da aeração nasal e rinomanometria, das 16 medidas comparativas entre pré e pós-irrigação nasal, constataram-se mudanças significativas na aeração nasal e na resistência nasal. A irrigação nasal resultou em melhora nas medidas da aeração nasal, enquanto para o fluxo nasal da rinomanometria, as medidas permaneceram inalteradas entre pré e pós-irrigação nasal.

ABSTRACT Several studies have shown the importance of quantitative assessment in nasal patency and functional status of the upper airways to provide clinical and diagnostic information in oral breather individuals, which are of great interest to speech therapy. The aim of the study was to evaluate the effect of nasal saline solution irrigation on the upper airways through nasal aeration and active anterior rhinomanometry in oral breathing children. This was an eight case series study, carried out in children aged 7 to 10 years with an otorhinolaryngological clinical diagnosis of mouth breathing. The study consisted of three stages: (I) initial evaluation; (II) intervention; and (III) final evaluation. The questionnaires of the Index for the Identification of Oral Breathing Signs and Symptoms and disease-specific quality of life in pediatric patients with sinonasal complaints were applied, nasal aeration assessments and the anterior active rhinomanometry exam were carried out. The intervention was performed by irrigating nasal saline solution with 10ml. Afterwards, they were re-evaluated by nasal aeration evaluation and rhinomanometry to compare the results. Regarding nasal aeration and rhinomanometry evaluation, from the 16 comparative measurements between pre and post nasal irrigation, we obtained significant changes in nasal aeration and nasal resistance. Nasal irrigation resulted in improvement in nasal aeration measurements while nasal flow measurements from rhinomanometry remained unchanged considering pre and post nasal irrigation.

Relationship between microcephaly and indicators of social inequality in the state of Paraíba, Brazil

ABSTRACT Objective To analyze the relationship between microcephaly and social inequality indicators in the state of Paraíba during the biennium January 2015 and December 2016. Methods Ecological study with data from newborn microcephaly records and municipal socioeconomic, environmental, and demographic indicators was conducted using two health information systems from the Brazilian Ministry of Health (SINASC and SINAN) and the Brazilian Institute of Geography and Statistics. A Poisson multiple regression model was applied with a significance level of 5%. Results Among 223 municipalities in Paraíba, 74 registered new cases of microcephaly. The number of Zika virus cases, number of inhabitants, number of households without adequate water supply, and household income were predictor variables of the number of new cases of microcephaly in Paraíba. Conclusion Microcephaly is associated with indicators of social inequality in Paraíba. Zika virus cases, water supply, and family income are the indicators that best explain the increase in microcephaly cases. Therefore, these variables must be monitored by health professionals and authorities.

Effects of lingual frenotomy on breastfeeding and electrical activity of the masseter and suprahyoid muscles / Efeito da frenotomia lingual na amamentação e na atividade elétrica dos músculos masseter e supra-hióideos

ABSTRACT Purpose To analyze the effects of lingual frenotomy on the breastfeeding of infants, based on the electrical activity of the masseter and suprahyoid muscles and assessment of the breastfeeding. Methods Observational study developed between October 2017 and June 2018 with a sample of 20 newborns and infants who attended a dental clinic and were diagnosed with ankyloglossia. Another 20 were excluded for meeting some of the following exclusion criteria: babies more than 6 months old, who were not on exclusive or mixed breastfeeding, who had other clinical impairments that interfered with breastfeeding, who had other foods introduced into their diet, who had neurological changes and/or craniofacial deformities, and/or who did not finish all the stages of the study. Breastfeeding was assessed with the UNICEF Breastfeeding Assessment and Observation Protocol, while the muscle electrical activity was assessed with the Electrical Activity Assessment Protocol for the Masseter and Suprahyoid Muscles in Newborns During Breastfeeding. The same speech-language-hearing therapist conducted the two assessments both before the conventional frenotomy and 7 days after it. Results The signs suggestive of breastfeeding difficulties changed 7 days after the surgery, with a p-value ≤ 0.002 for general observation of the mother, position of the infant, latch, and sucking. The maximum voluntary contraction of the masseter was the only integral parameter with a difference, as the electrical activity had decreased. Conclusion Behaviors favorable to breastfeeding increased 7 days after the frenotomy in all the breastfeeding assessment categories, whereas the electrical activity of the masseter decreased.

RESUMO Objetivo Analisar os efeitos da frenotomia lingual na amamentação de recém-nascidos, com base na atividade elétrica dos músculos masseter e supra-hióideos e avaliação da mamada. Método Estudo observacional, desenvolvido entre outubro de 2017 e junho de 2018. Amostra de 20 recém-nascidos e lactentes de uma clínica odontológica, diagnosticados com anquiloglossia; 20 foram excluídos por se encaixarem em algum dos critérios de exclusão: ter mais de seis meses de vida, não fazer aleitamento materno exclusivo ou misto, apresentar outro comprometimento clínico que interfira na amamentação, ter iniciado a ingestão de outros alimentos, alterações neurológicas e/ou deformidades craniofaciais e não ter finalizado todas as etapas do estudo. A avaliação da amamentação seguiu o Protocolo de Observação e Avaliação da Mamada da UNICEF, e a avaliação da atividade elétrica muscular o Protocolo de Avaliação da Atividade Elétrica dos Músculos Masseter e Supra-hióideos em Recém-Nascidos Durante a Alimentação, ambas realizadas pela mesma fonoaudióloga antes da frenotomia convencional e sete dias após. Resultados Os sinais sugestivos de dificuldade na amamentação mudaram sete dias após a cirurgia, com valor de p≤0,002 para a observação geral da mãe, posição do bebê, pega e sucção. Houve diferença apenas no parâmetro integral da Contração Voluntária Máxima do masseter, com diminuição da atividade elétrica. Conclusão Sete dias após a frenotomia observou-se aumento de comportamentos favoráveis ​​à amamentação em todas as categorias de avaliação da mamada e diminuição da atividade elétrica do masseter.

Neurofeedback therapy used to treat sleep bruxism in adult subjects: a scoping review protocol

ABSTRACT Purpose: to identify evidence regarding the treatment of sleep bruxism with neurofeedback, as well as gaps in such evidence, through mapping studies, and how treatment protocols were performed. Methods: the proposed review will be conducted in accordance with the JBI methodology for scope reviews. The search strategy will aim to locate published and unpublished studies. The main databases to search include MEDLINE, Embase, LILACS, PsycINFO, Web of Science and Scopus. Gray literature and relevant materials will be included. Two independent reviewers will select titles and abstracts for evaluation, according to the inclusion criteria for the review. The search results will be reported and presented in a PRISMA flowchart. Data will be extracted from materials included in the scoping review using a data extraction tool. The results found will be presented in an organized table with the variables, with data being presented through diagrams, narratives and tables. Conclusion: a narrative summary will be performed that will accompany the tabulated results and describe the relationship of these results with the objectives and questions of this scoping review, that may lead to encouraging further research on this topic, bringing a new clinical approach evidence to the management of sleep bruxism.

Nasal airflow measures and peak inspiratory flow in mouth-breathing children before and after nasal cleansing and massage maneuvers / Medidas da aeração nasal e fluxo máximo inspiratório em crianças com respiração oral pré e pós manobras de limpeza e massagem nasal

ABSTRACT This study aimed at investigating the effects of nasal cleansing and massage maneuvers on upper airway patency in mouth-breathing children. This is a case report on eight children, aged 7 to 10 years, with a speech-language-hearing diagnosis of mouth breathing and otorhinolaryngological assessment and clinical diagnosis of rhinitis. Nasal airflow and patency were respectively assessed with the Glatzel mirror and Peak Nasal Inspiratory Flow (PNIF). Then, they were submitted to nasal cleansing and massage maneuvers with a saline solution, followed by reassessment with the Glatzel mirror and PNIF to compare results. The medians of total nasal airflow quantification were significant. Data on unilateral nasal cavity measurement indicated a sharp increase in nasal airflow in each nostril, with statistically significant differences between before and after nasal cleansing and massage maneuvers. The medians of the total PNIF were significant after the cleansing. It is concluded that the nasal airflow increased in PNIF after the cleansing maneuver.

RESUMO Esse estudo objetivou investigar o efeito da manobra de limpeza e massagem nasal na permeabilidade da via aérea superior de crianças com respiração oral. Trata-se de um relato de caso no qual foram selecionadas oito crianças com idade entre 7 a 10 anos apresentando diagnóstico fonoaudiológico de respiração oral, com avaliação otorrinolaringológica e diagnóstico clínico de rinites. Realizou-se as avaliações da aeração nasal e permeabilidade nasal, utilizando o espelho milimetrado de Altmann e o Peak Nasal Inspiratory Flow (PNIF), respectivamente. Em seguida, executou-se as manobras de limpeza e massagem nasal com soro fisiológico. Ao término, utilizou-se novamente o espelho de Altmann e o PNIF para comparar os resultados. Os resultados obtidos pelas medianas na quantificação da aeração nasal total foram significantes. Os dados da mensuração das cavidades nasais unilateralmente indicaram aumento acentuado na aeração nasal em cada narina, tendo diferenças estatisticamente significante quando comparados com os valores antes e depois das manobras de limpeza e massagem nasal. Os valores obtidos pelas medianas no Fluxo Nasal Máximo Inspiratório Total foram significantes após a limpeza. Concluiu-se que houve aumento da aeração nasal no fluxo nasal máximo inspiratório após manobra de limpeza.

Relação do processamento sensorial e sistema estomatognático de crianças respiradoras orais / Relation of sensory processing and stomatognical system of oral respiratory children

RESUMO Objetivo Verificar a relação entre o processamento sensorial e as alterações das funções do Sistema Estomatognático de crianças respiradoras orais, caracterizando o processamento sensorial destas e comparando-o com o de respiradoras nasais. Método Foram selecionadas 50 crianças (5 a 12 anos) que apresentaram diagnóstico de respiração oral e 50 sem sinais e sintomas de respiração oral ou rinite alérgica para fazer parte do grupo controle, pareadas por idade e sexo. As crianças respiradoras orais e nasais passaram por avaliação do processamento sensorial, através da Sensory Processing Measure - Home form, e as respiradoras orais por avaliação da motricidade orofacial através da Avaliação Miofuncional Orofacial com Escore. Os resultados foram apresentados em forma de tabela e com suas respectivas frequências absoluta e relativa. Resultados A maioria das crianças avaliadas foi do sexo masculino, estando com idade média de 8 anos. A maioria dos respiradores orais apresentou alteração no processamento de todos os sentidos, com relação estatisticamente significativa quando comparados com os respiradores nasais. Houve relação, nos respiradores orais, entre o processamento sensorial proprioceptivo e o movimento das bochechas, processamento sensorial visual e movimentação da cabeça durante a deglutição e entre o tipo de mastigação e o processamento sensorial tátil. Conclusão Após análise dos dados foi possível perceber que o processamento sensorial de todos os sistemas se apresenta com alteração nos respiradores orais e que esse mau processamento se relaciona a mobilidade orofacial, bem como com funções do Sistema Estomatognático, além do tipo de mastigação dessa população.

ABSTRACT Purpose To verify the relationship between sensory processing and changes in the functions of the stomatognathic system in mouth breathing children, characterizing their sensory processing and comparing it with that of nasal breathing children. Methods 50 children (5 to 12 years) who were diagnosed with mouth breathing and 50 without signs and symptoms of mouth breathing or allergic rhinitis were selected to be part of the control group, matched for age and sex. Oral and nasal breathing children underwent sensory processing evaluation, through the Sensory Processing Measure - home form, and mouth breathers, through the evaluation of orofacial motricity through the Orofacial Myofunctional Evaluation with score. The results were presented in table form and with their respective absolute and relative frequencies. Results Most of the children evaluated were male, with an average age of eight years. Most mouth breathers presented alteration in the processing of all senses, with a statistically significant relationship when compared to nasal breathers. There was a relationship, in mouth breathers, between proprioceptive sensory processing and the movement of the cheeks, visual sensory processing and head movement during swallowing, and between the type of chewing and tactile sensory processing. Conclusion After analyzing the data, it was possible to see that the sensory processing of all systems presents with changes in mouth breathers and that this poor processing is related to orofacial mobility, as well as functions of the stomatognathic system, in addition to the type of chewing of this population.

The effects of lingual frenotomy on breastfeeding: an integrative review

ABSTRACT Purpose: to investigate what effects lingual frenotomy has on breastfeeding. Methods: based on the research question - "Is there a relationship between the improvement in breastfeeding and the lingual frenotomy?" -, a bibliographical survey was carried out in three databases, using the following descriptors: ankyloglossia, lingual frenum, breastfeeding and frenotomy. Frenotomy is a free term. Original articles with babies up to 6 months old who had difficulties breastfeeding due to ankyloglossia and who had been submitted to lingual frenotomy were chosen. An instrument was developed, containing the following information: name of the authors, year of publication, country of origin, the objective of the study, type of study, sample, main results, and conclusion. Literature Review: of the 243 articles screened, four met the inclusion criteria for this study. It was observed that, after lingual frenotomy, some changes may take place in breastfeeding patterns, such as an increase in the number of suctions and a decrease in the time of pause in between series of suctions. Conclusion: the lingual frenotomy can be an important procedure in the treatment of babies with ankyloglossia, possibly helping improve the latch and breastfeeding.

Relation of sensory processing and stomatognical system of oral respiratory children. / Relação do processamento sensorial e sistema estomatognático de crianças respiradoras orais.

PURPOSE: To verify the relationship between sensory processing and changes in the functions of the stomatognathic system in mouth breathing children, characterizing their sensory processing and comparing it with that of nasal breathing children. METHODS: 50 children (5 to 12 years) who were diagnosed with mouth breathing and 50 without signs and symptoms of mouth breathing or allergic rhinitis were selected to be part of the control group, matched for age and sex. Oral and nasal breathing children underwent sensory processing evaluation, through the Sensory Processing Measure - home form, and mouth breathers, through the evaluation of orofacial motricity through the Orofacial Myofunctional Evaluation with score. The results were presented in table form and with their respective absolute and relative frequencies. RESULTS: Most of the children evaluated were male, with an average age of eight years. Most mouth breathers presented alteration in the processing of all senses, with a statistically significant relationship when compared to nasal breathers. There was a relationship, in mouth breathers, between proprioceptive sensory processing and the movement of the cheeks, visual sensory processing and head movement during swallowing, and between the type of chewing and tactile sensory processing. CONCLUSION: After analyzing the data, it was possible to see that the sensory processing of all systems presents with changes in mouth breathers and that this poor processing is related to orofacial mobility, as well as functions of the stomatognathic system, in addition to the type of chewing of this population.

OBJETIVO: Verificar a relação entre o processamento sensorial e as alterações das funções do Sistema Estomatognático de crianças respiradoras orais, caracterizando o processamento sensorial destas e comparando-o com o de respiradoras nasais. MÉTODO: Foram selecionadas 50 crianças (5 a 12 anos) que apresentaram diagnóstico de respiração oral e 50 sem sinais e sintomas de respiração oral ou rinite alérgica para fazer parte do grupo controle, pareadas por idade e sexo. As crianças respiradoras orais e nasais passaram por avaliação do processamento sensorial, através da Sensory Processing Measure ­ Home form, e as respiradoras orais por avaliação da motricidade orofacial através da Avaliação Miofuncional Orofacial com Escore. Os resultados foram apresentados em forma de tabela e com suas respectivas frequências absoluta e relativa. RESULTADOS: A maioria das crianças avaliadas foi do sexo masculino, estando com idade média de 8 anos. A maioria dos respiradores orais apresentou alteração no processamento de todos os sentidos, com relação estatisticamente significativa quando comparados com os respiradores nasais. Houve relação, nos respiradores orais, entre o processamento sensorial proprioceptivo e o movimento das bochechas, processamento sensorial visual e movimentação da cabeça durante a deglutição e entre o tipo de mastigação e o processamento sensorial tátil. CONCLUSÃO: Após análise dos dados foi possível perceber que o processamento sensorial de todos os sistemas se apresenta com alteração nos respiradores orais e que esse mau processamento se relaciona a mobilidade orofacial, bem como com funções do Sistema Estomatognático, além do tipo de mastigação dessa população.

The use of photobiomodulation for the muscles of head and neck: an integrative review / O uso da fotobiomodulação nos músculos da cabeça e pescoço: revisão integrativa da literatura

ABSTRACT Purpose To carry out an integrative review of the literature on the use of photobiomodulation (PBM) for the head and neck muscles. Research strategy The research took place between June/2019 and March/2021, in the following databases: PubMed, Scopus, Web of Science, LILACS, and SciELO. The MeSH used were Low-Level Light Therapy, Phototherapy, Masseter Muscle, Masticatory Muscles, Tongue, Palate, Mouth, Neck Muscles, and Facial Muscles in English and Portuguese. No limitation was imposed on the year and language of publication. Selection criteria studies that answered the guiding question: what is the use of photobiomodulation to the head and neck muscles?. Results 2857 articles were found, of which 102 were selected for full reading, 52 of those were excluded, giving a total of 50 articles included. The included publications date from 2003 to 2020. Brazil was the country that most published on the topic. With regard to the objectives, 82% of the studies aimed to investigate the analgesic effect of PBM, of these, 50% were related to articular or muscular temporomandibular disorders (TMD). The heterogeneity of the studies makes it impossible to define the dose protocols. Conclusion PBM has been applied to the head and neck muscles mainly for the treatment of pain caused by TMD. There is no treatment protocol to define the doses to be used, due the heterogeneity of the methodologies applied and results found.

RESUMO Objetivos realizar uma revisão integrativa da literatura sobre o uso da fotobiomodulação nos músculos de cabeça e pescoço. Estratégia de pesquisa As buscar foram realizadas nas bases de dados: PubMed, Scopus, Web of Science, LILACS e SciELO. A pesquisa ocorreu entre junho de 2019 e março de 2021. Os descritores utilizados foram Terapia com Luz de Baixa Intensidade, Fototerapia, Músculo Masseter, Músculos Mastigatórios, Língua, Palato, Boca, Pescoço, Músculos do Pescoço, Músculos Faciais e seus respectivos termos em inglês. Não houve limitação de ano de publicação e idioma. Critérios de seleção estudos que respondessem a pergunta norteadora: qual o uso da fotobiomodulação na musculatura de cabeça e pescoço?. Resultados Foram encontrados 2857 artigos, sendo selecionados 102 para leitura completa, dos quais 52 foram excluídos, totalizando 50 artigos incluídos. As publicações incluídas datam de 2003 a 2020. O Brasil foi o país que mais publicou sobre o tema. Quanto aos objetivos, 82% dos estudos pesquisaram o efeito analgésico da fotobiomodulação, e desses, 50% eram relacionados à disfunção temporomandibular (DTM) articular ou muscular. A heterogeneidade dos estudos impossibilita a definição de protocolos dosimétricos. Conclusão A fotobiomodulação tem sido utilizada na musculatura de cabeça e pescoço principalmente para o tratamento da dor proveniente de DTM. Não existe um protocolo de aplicação que defina os parâmetros dosimétricos a serem utilizados, devido a heterogeneidade das metodologias e dos resultados encontrados.

Relationship between the electrical activity of suprahyoid musculature and tongue pressure during swallowing in the elderly / Relação entre a atividade elétrica da musculatura supra-hióidea e a pressão da língua durante a deglutição em idosos

ABSTRACT Purpose: to correlate the electrical activity of the suprahyoid musculature and tongue pressure during swallowing, in the elderly. Methods: thirteen elderly aged from 60 to 80 years participated in this study. They were submitted to electromyographic assessment and tongue pressure measurement while swallowing. After the evaluation, the relationship between suprahyoid musculature activity and tongue pressure during swallowing was verified. To obtain the electrical signal, surface electromyography was used and electrodes were placed in the submental region. They swallowed saliva and held the tongue against the palate for three seconds to record the maximum voluntary contraction, as well as saliva, and then, 50ml of water for the electromyographic recording. Tongue pressure was measured using the Iowa Oral Performance Instrument during swallowing of 10ml of water. Swallowing was performed with a bulb positioned between the dorsum of the tongue and the hard palate. Statistical analysis was carried out by using Spearman's rank correlation coefficient. Results: there was a relationship between the electrical activity of the suprahyoid musculature and tongue pressure, during water swallowing (p=0.093%), showing an increase in the maximum tongue pressure level as the electrical activity increased, while swallowing. Conclusion: the values of tongue pressure and electrical activity of the suprahyoid musculature are related when swallowing in the presence of a greater volume of liquid to be swallowed.

RESUMO Objetivo: correlacionar a atividade elétrica da musculatura supra-hióidea e a pressão da língua durante a deglutição em idosos. Métodos: participaram deste estudo treze idosos entre 60 e 80 anos de idade. Foram submetidos a avaliação eletromiográfica e aferimento do nível pressórico da língua, durante a atividade de deglutição. Após a avaliação, foi verificada a relação entre a atividade da musculatura supra-hióidea e a pressão da língua durante a deglutição. Para captação do sinal elétrico, foi utilizada a eletromiografia e foram posicionados eletrodos na região submentual. Eles realizaram a deglutição de saliva e mantiveram a língua pressionada contra o palato por três segundos para registro da contração voluntária máxima, e deglutição de saliva e, depois, 50 ml de água para o registro eletromiográfico. A pressão da língua foi mensurada por meio do Iowa Oral Performance Instrument durante a deglutição de 10 ml de água. A deglutição foi realizada com bulbo posicionado entre o dorso da língua e o palato duro. A análise estatística foi realizada por meio do teste coeficiente de correlação de Spearman. Resultados: houve relação entre a atividade elétrica da musculatura supra-hióidea e a pressão da língua durante a deglutição de água (p= 0,093%), demonstrando um aumento no nível máximo de pressão da língua ao passo que a atividade elétrica aumentava, durante a deglutição. Conclusão: houve os valores de nível pressórico da língua e de atividade elétrica da musculatura supra-hióidea se relacionam na deglutição quando há presença de maior volume de líquido a ser deglutido.

Alterações sensoriais em respiradores orais: revisão sistemática baseada no método prisma / Sensory changes in mouth breathers: systematic review based on the prisma method

RESUMO Objetivo: Revisar, na literatura, estudos que abordem alterações nos sistemas sensoriais apresentadas por respiradores orais. Fonte de dados: A busca foi realizada nas bases de dados PubMed, BIREME, LILACS, Web of Science e Scopus. A busca foi realizada independentemente por dois pesquisadores, seguindo os critérios de seleção. Foram selecionados artigos originais que abordaram a respiração oral e as alterações nos sistemas sensoriais publicados nos idiomas português, inglês e espanhol. Os artigos de revisão da literatura, as dissertações, os capítulos de livros, os estudos de caso e os editoriais foram excluídos. Síntese dos dados: Foram encontrados 719 artigos, dos quais 663 foram excluídos pelo título e 22 pelo resumo. Trinta e quatro manuscritos foram analisados, dos quais 23 estavam repetidos e 8 foram excluídos pelo texto lido na íntegra. Assim, três artigos foram selecionados para esta revisão. Conclusões: A maioria dos estudos apresenta a ocorrência de alterações dos sistemas sensoriais em crianças respiradoras orais. Contudo, observa-se maior preocupação na avaliação da recepção sensorial. Além disso, a avaliação dos sistemas sensoriais foi realizada de forma não padronizada, o que pode ter acarretado resultados menos precisos na população estudada.

ABSTRACT Objective: To review, in the literature, information regarding changes in the sensory systems of mouth breathers. Data sources: The search was conducted in the following databases PubMed, BIREME, LILACS, Web of Science and Scopus. The search was independently carried out by two researchers, following the selection criteria. Original articles that approached mouth breathing and changes in sensory systems published in Portuguese, English and Spanish were published. Literature review of articles, dissertations, book chapters, case studies and editorials were excluded. Data synthesis: We found 719 articles. Among them, 663 were excluded by the title and 22 by the summary. Among the 34 analyzed manuscripts, 23 were repeated and 8 were excluded by reading the full text. Thus, 3 articles were selected for this review. Conclusions: Most studies presents the occurrence of changes in sensory systems in mouth breathing children. However, sensory reception is a matter of more concern. Besides, the evaluation of sensory systems was not standardized, which may have led to less precise results in the studied population.

SENSORY CHANGES IN MOUTH BREATHERS: SYSTEMATIC REVIEW BASED ON THE PRISMA METHOD. / ALTERAÇÕES SENSORIAIS EM RESPIRADORES ORAIS: REVISÃO SISTEMÁTICA BASEADA NO MÉTODO PRISMA.

OBJECTIVE: To review, in the literature, information regarding changes in the sensory systems of mouth breathers. DATA SOURCES: The search was conducted in the following databases PubMed, BIREME, LILACS, Web of Science and Scopus. The search was independently carried out by two researchers, following the selection criteria. Original articles that approached mouth breathing and changes in sensory systems published in Portuguese, English and Spanish were published. Literature review of articles, dissertations, book chapters, case studies and editorials were excluded. DATA SYNTHESIS: We found 719 articles. Among them, 663 were excluded by the title and 22 by the summary. Among the 34 analyzed manuscripts, 23 were repeated and 8 were excluded by reading the full text. Thus, 3 articles were selected for this review. CONCLUSIONS: Most studies presents the occurrence of changes in sensory systems in mouth breathing children. However, sensory reception is a matter of more concern. Besides, the evaluation of sensory systems was not standardized, which may have led to less precise results in the studied population.

OBJETIVO: Revisar, na literatura, estudos que abordem alterações nos sistemas sensoriais apresentadas por respiradores orais. FONTE DE DADOS: A busca foi realizada nas bases de dados PubMed, BIREME, LILACS, Web of Science e Scopus. A busca foi realizada independentemente por dois pesquisadores, seguindo os critérios de seleção. Foram selecionados artigos originais que abordaram a respiração oral e as alterações nos sistemas sensoriais publicados nos idiomas português, inglês e espanhol. Os artigos de revisão da literatura, as dissertações, os capítulos de livros, os estudos de caso e os editoriais foram excluídos. SÍNTESE DOS DADOS: Foram encontrados 719 artigos, dos quais 663 foram excluídos pelo título e 22 pelo resumo. Trinta e quatro manuscritos foram analisados, dos quais 23 estavam repetidos e 8 foram excluídos pelo texto lido na íntegra. Assim, três artigos foram selecionados para esta revisão. CONCLUSÕES: A maioria dos estudos apresenta a ocorrência de alterações dos sistemas sensoriais em crianças respiradoras orais. Contudo, observa-se maior preocupação na avaliação da recepção sensorial. Além disso, a avaliação dos sistemas sensoriais foi realizada de forma não padronizada, o que pode ter acarretado resultados menos precisos na população estudada.

Quantitative evaluation of tongue pressure in children with oral breathing / Avaliação quantitativa da pressão de língua em crianças com respiração oral

ABSTRACT Objective: to quantify tongue pressure in children with oral breathing and to describe their respiratory clinical manifestations, comparing them to the objective evaluation Methods: the study was performed with 60 children, four to nine years old, treated at the outpatient clinics of the Pernambuco Clinical Hospital, Federal University of Pernambuco, distributed into two groups, with and without oral breathing. The collection consisted of a survey of respiratory clinical manifestations, application of the protocol on respiratory mode and assessment of tongue pressure, using the Iowa Oral Performance Instrument (IOPI). Results: male predominance and correlation between diagnosis of allergic rhinitis and/or nasal obstruction and the clinical diagnosis of oral breathing were observed. There was a statistically significant difference between the groups for usual position of open lips, open mouth, sagging facial expression muscles, narrow nostrils, shortened upper and everted lower lip. The mean tongue pressure in children with oral and nasal breathing presented a mean of 38.27 Kpa and 53.73 Kpa, respectively. Conclusion: tongue pressure decreased in children with oral breathing, corroborating that which is reported in the literature. There was agreement between the results of respiratory clinical characteristics and the objective evaluation.

RESUMO Objetivo: quantificar a pressão de língua em crianças com respiração oral e descrever as suas manifestações clínicas respiratórias, comparando-as à avaliação objetiva. Métodos: o estudo foi realizado com 60 crianças de 04 a 09 anos de idades atendidas nos ambulatórios do Hospital das Clínicas da Universidade Federal de Pernambuco, distribuídas em dois grupos, com e sem respiração oral. A coleta constou do levantamento das manifestações clínicas respiratórias, da aplicação do protocolo sobre o modo respiratório e da avaliação da pressão de língua utilizando o Iowa Oral Performance Instrument (IOPI). Resultados: observou-se predominância do sexo masculino e correlação entre o diagnóstico clínico de rinite alérgica e/ou obstrução nasal com o diagnóstico clínico de Respiração oral. Houve diferença estatisticamente significante entre os grupos para posição habitual dos lábios entreabertos, boca aberta, flacidez dos músculos da expressão facial, narinas estreitas, lábio superior encurtado e inferior evertido. As médias das pressões de língua em crianças com respiração oral e nasal apresentaram médias de 38,27 Kpa e 53,73 Kpa, respectivamente. Conclusão: foi verificada diminuição da pressão de língua em crianças com respiração oral, corroborando com o que é referido na literatura. Houve concordância entre os resultados das características clínicas respiratórias com a avaliação objetiva.

Interferência das variáveis sexo e idade no olfato e no paladar em crianças com e sem rinite alérgica / Interference of variables sex and age in olfaction and taste of children with and without allergic rhinitis

RESUMO Objetivo Investigar associação de olfato e paladar com a idade e o sexo, em crianças com e sem rinite alérgica. Métodos Estudo observacional, comparativo, analítico e transversal. Amostra composta por 127 crianças, sendo 85 sem rinite alérgica e 42 com rinite alérgica, entre 7 e 12 anos de idade, atendidas no Hospital das Clínicas da Universidade Federal de Pernambuco. Foi realizada revisão de prontuário, entrevista com os responsáveis, limpeza nasal, avaliação do olfato por meio de teste embasado na literatura - desenvolvido para esta pesquisa -, higienização bucal e avaliação do paladar, mediante teste das tiras gustativas. Os dados foram tabulados e analisados no programa estatístico SPSS 17.0 e considerou-se o nível de significância de 5%. Utilizou-se o Teste Qui-quadrado ou exato de Fisher, além da frequência absoluta e relativa dos dados. Resultados O estudo evidenciou semelhanças entre os níveis de discriminação olfatória e gustatória em sexos e faixas etárias diferentes, nas crianças com e sem rinite alérgica, observada ausência de associações estatisticamente significativas nestas condições. Conclusão Os resultados do estudo se contrapõem à literatura pesquisada, porém contribuem no estabelecimento de escores da quantificação olfatória e gustativa para sexos e idades diferentes, em crianças com e sem rinite alérgica.

ABSTRACT Purpose To associate smell and taste with age and sex of children with and without allergic rhinitis. Methods This is an observational, comparative, analytical and cross-sectional study with a sample of 127 children, 85 without allergic rhinitis and 42 with allergic rhinitis aged 7-12 years attended at the Clinics Hospital of Pernambuco. The research started on January 2012 and was approved by the Ethics Research Committee. The Free and Informed Consent Form was applied, then, medical report review, interview with parents / caregivers, nasal cleaning, evaluation of smell using a test based on literature developed for this study, oral hygiene and taste evaluation using the taste strip test were performed. Data were analyzed using the SPSS 17.0 software, considering 0.05 significance level using the Chi-square or Fisher's exact test, in addition to absolute and relative frequency data. Results The study highlights similarities between levels of olfactory and gustatory discrimination between different sexes and age groups of children (with and without allergic rhinitis), as there is lack of statistically significant associations under these conditions. Conclusion The study results contradict literature findings, but contribute in establishing olfactory and gustatory quantification scores for different ages and sexes of children with and without allergic rhinitis.

Chewing preference and its relationship with postural muscular electric potential

ABSTRACT Objective: to verify if the chewing side preference interferes in the postural muscular electrical potential. Methods: fifty-five volunteers (41 women and 14 men; average age of 26 years) were evaluated by Odontology (determining the type of dental occlusion), by a speech therapist (determining the chewing side preference) and by a physiotherapist (evaluating the postural muscular electrical potential). The three professionals had no communication regarding the evaluations, in order to keep the study partially blind. For chewing preference electrognatography was used for muscles: sternocleidomastoid, upper trapezium, gluteus medius and tibialis anterior, bilaterally, in static orthostatic posture. Results: there was statistical significance for the muscular electrical potential of the sternocleidomastoid and anterior tibial, when there was right chewing preference (p=0.030 for both) and left chewing preference (p=0.0028 and p=0.0020, respectively). In alternate bilateral chewing there was tendency to symmetry of postural muscular electrical activation, in all muscles. Conclusion: there was presence of asymmetry of postural muscular electrical activation in the sternocleidomastoid and tibialis anterior, when chewing side preference was at right or left. In the presence of alternate bilateral mastication, there was tendency of symmetry of postural muscular electrical activation for all studied musculatures.

Motor imagery and swallowing: a systematic literature review / Imagética motora e deglutição: uma revisão sistemática da literatura

ABSTRACT Objetive: to identify, in the literature, studies that address the use of motor imagery of swallowing. Methods: a systematic review in SCOPUS databases, Science Direct and Medline, with descriptors and free terms "Motor Imagery"; "Swallow"; "Feeding"; "Stomatognathic System"; "mastication ", "Chew "; "Deglutition "; "Deglutition Disorders "; and "Mental Practice". Original articles using the motor imagery of swallowing were included, while reviews were excluded. For data analysis, at the first and second steps, the reading of titles and abstracts of the studies was carried out. In the third step, all studies that were not excluded were read in full. Results: four manuscripts were selected. The use of motor imagery in the rehabilitation of swallowing shows to be a recent proposal (2014-2015). The sample was reduced and comprised mainly healthy individuals. The EMG of the supra-hyoid muscles was used in two manuscripts. The most used neuroimaging technique was the Near-Infrared Spectroscopy, demonstrating the occurrence of hemodynamic changes during motor imagery and motor execution of swallowing. Conclusion: the motor imagery produces brain response in the motor area of the brain, suggesting that mentalization of actions related to swallowing is effective. However, further studies are needed for the application of this approach in the swallowing rehabilitation.

RESUMO Objetivo: identificar na literatura os estudos que abordem o uso da imagética motora da deglutição. Métodos: uma revisão sistemática nas bases de dados SCOPUS, Science Direct e MedLine, com os descritores e termos livres: "Motor Imagery"; "Swallow"; "Feeding"; "Stomatognathic System"; "Mastication", "Chew"; "Deglutition"; "Deglutition Disorders"; e "Mental Practice". Incluídos artigos originais, com o uso da imagética motora da deglutição. Excluídas as revisões. Para análise dos dados, na primeira e segunda etapas foram realizadas a leitura dos títulos e dos resumos dos estudos. Na terceira etapa, todos os estudos que não foram excluídos foram lidos na íntegra. Resultados: foram selecionados 4 manuscritos. O uso da imagética motora na reabilitação da deglutição suscita ser uma proposta recente (2014 - 2015). A amostra foi reduzida e composta majoritariamente por indivíduos saudáveis. A Eletromiografia dos músculos supra-hioides foi utilizada em dois manuscritos. A técnica de neuroimagem mais utilizada foi o Near-Infrared Spectroscopy, demonstrando a ocorrência de mudanças hemodinâmicas durante a imagética motora e execução motora da deglutição. Conclusão: identificou-se que a imagética motora produz resposta cerebral na área motora do cérebro, sugerindo que a mentalização das ações relacionadas à deglutição é eficaz. No entanto, são necessários novos estudos para aplicação desta abordagem na reabilitação da deglutição.

Amplitude e velocidade dos movimentos mastigatórios em pacientes com doença de Parkinson / Amplitude and speed of masticatory movements in patients with Parkinson's disease

RESUMO Objetivo: caracterizar a amplitude e a velocidade dos ciclos mastigatórios avaliados por eletrognatografia em um grupo de indivíduos idosos e confrontar esses dados com outros dois grupos de sujeitos com doença de Parkinson (DP) diferenciados pela característica motora predominante. Métodos: os 42 participantes foram divididos em três grupos: A com 15 voluntários e média de idade de 62 anos, sendo 8 do sexo feminino; B com 14 voluntários Parkinsonianos com rigidez predominante e média etária de 58 anos, dos quais 7 eram mulheres; e o grupo C com 13 voluntários, com DP e tremor predominante, com média de idade de 64 anos, sendo 4 mulheres. Empregou-se o teste ANOVA para diferença de médias, com contraste post-hoc de Dunnett ou teste t de Student, todos em nível de significância de 0,05. Resultados: houve maiores diferenças entre as medias dos grupos A e B no numero total de ciclos mastigatórios (A= 23,13 ± 1,41 B=18,21 ± 1,70) [p=0,034] e nas amplitudes máxima de abertura de boca (A= 34,66 ± 2,04 B=26,72 ± 2,49) [p=0,018], lateralização para direita (A=7,02 ± 0,59 B=5,80 ± 0,97) [p=0,036] e para esquerda (A=6,44 ± 0,64 B=3,35 ± 0,80) [p=0,039]. Conclusão: tendo o grupo de idosos superado as medias, na movimentação mandibular durante a mastigação, do grupo de parkinsonianos com rigidez significativamente. Podemos concluir que, é provável que fatores como a rigidez parkinsoniana possam comprometer a mastigação de indivíduos com a doença de Parkinson.

ABSTRACT Purpose: to characterize the amplitude and speed of masticatory cycles evaluated by electrognathography in one group of elder individuals and to compare these data with those of two other groups of Parkinson's disease subjects. Methods: 42 volunteers participants in this study were divided into three groups: A with 15 volunteers, average age of 62 years, 8females, B with 14 volunteers characterized by a Parkinson’s hypokinesia, average age of 58 years, of which 7 are female, and C with 13 volunteers characterized by a Parkinson’s tremor, with average age of 64 years, being 4 female. It was used the ANOVA test for difference of means with post-hoc Dunnett's contrast or Student's t-test, all at 0.05 significance level. Results: there were greater differences between the means of groups A and B in the total number of masticatory cycles (A = 23.13 ± 1.41 B = 18.21 ± 1.70) [p = 0.034] and in the maximum mouth opening amplitudes (A = 34.66 ± 2.04 B = 26.72 ± 2.49) [p = 0.018], lateralization to the right (A = 7.02 ± 0.59 B = 5.80 ± 0.97) P = 0.036] and left (A = 6.44 ± 0.64 B = 3.35 ± 0.80) [p = 0.039]. Conclusion: the elderly group exceeded the means, in the mandibular movement during chewing, of the rigid group of parkinsonians. We may conclude that factors such as parkinsonian stiffness are likely to compromise the chewing of individuals with Parkinson's disease.

Change in the nose areas in children with mouth breathing after nasal cleansing and massage. / Mudança nas áreas nasais em crianças com respiração oral após a limpeza e massagem nasal.

PURPOSE: To analyze the changes occurred in the nasal cavity geometry, before and after nasal cleansing, through nasal aeration and acoustic rhinometry in children with oral breathing. METHODS: Twenty children aged four to 12 years were included in the study. The gathering of participants was conducted at the Multifunctional Laboratory of the Speech Pathology Department of the Federal University of Pernambuco - UFPE. The following procedures were conducted: Identification Index of Signs and Symptoms of Oral Breathing; marking of nasal expiratory airflow using the graded mirror of Altmann, and examination of the Nasal Geometry by Acoustic Rhinometry. The same procedures were performed after nasal massage and cleansing with saline solution. RESULTS: Significant change was observed in the areas with respect to the nasal airflow on both sides after nasal cleansing and massage. As for nasal geometry, measured by acoustic rhinometry, comparison between the nostrils showed that the effect of cleansing and massage was discrete. CONCLUSION: Nasal aeration measures showed sensitivity to the cleansing and massage technique and measures of nasal geometry confirmed its effect on respiratory physiology.