Tongue function, salivary flow rate and IgA, IgM and IgG total salivary levels in chronic chagasic patients

Although microscopic alterations have been detected in tongues and salivary glands of chagasic patients and the identification of biomarkers in saliva has proved advantageous, there are no studies evaluating tongue function and total salivary IgA, IgG and IgM levels in chronic chagasic patients. The aim of this study was to evaluate tongue function, salivary flow rate, and total salivary IgA, IgG and IgM levels comparing chronic and non-infected individuals. 37 patients were selected: chronic cardiac chagasic patients (n=6), chronic chagasic patients with the associated form of the disease (cardiopathy and megaesophagus) (n=11), and non-chagasic individuals (n=20). The tongue function underwent a phonoaudiological evaluation. The salivary flow rate was measured by sialometry. The total salivary IgA, IgG and IgM levels were evaluated by sandwich ELISA assay. Chagasic patients with the associated form of the disease presented higher salivary flow rate and lower salivary protein levels. No significant differences were noted in the lingual function or in the total salivary immunoglobulin levels among the groups. Although patients with chagasic megaesophagus presented higher levels of salivary flow and lower salivary protein, the fact that there were no significant differences in lingual function and total salivary immunoglobulin levels among the groups led to the conclusion that chronic chagas disease does not modify the lingual function or the total IgA, IgG and IgM salivary levels. The present study was the first to evaluate the function of the tongue and salivary total immunoglobulin levels in Chagas disease.

Relação entre disfunção temporomandibular e alterações auditivas / The relationship among temporomandibular dysfunction and hearing alterations

TEMA: o equilíbrio das estruturas e funções do sistema estomatognático depende do adequado funcionamento da Articulação Temporomandibular, e esta, por sua vez, precisa da oclusão dental correta para a realização das funções ao movimentar a mandíbula. O desequilíbrio muscular ou estrutural da Articulação Temporomandibular poderá acarretar em uma disfunção dessa articulação e causar sinais e sintomas diversos como manifestações auditivas do tipo zumbido e otalgia. OBJETIVO: realizou-se a revisão de literatura das áreas de fonoaudiologia, otorrinolaringologia e odontologia com pesquisas em bases de dados, artigos e livros, sendo selecionadas as literaturas de 1992 a 2008 relacionadas ao tema do trabalho, a fim de associar sintomas audiológicos com a Disfunção Temporomandibular e apontar a importância da atuação multiprofissional, dando ênfase à atuação fonoaudiológica, em tal disfunção. CONCLUSÃO: várias são as hipóteses que tentam explicar a relação existente entre a Disfunção Temporomandibular e as alterações auditivas. Verificamos que há um vínculo entre o sistema estomatognático e o sistema auditivo. Contudo, mais importante que somente associar os sistemas estomatognático e auditivo, a equipe multiprofissional envolvida na assistência à pacientes com Disfunção Temporomandibular, precisa ter conhecimento a respeito da anatomia e fisiologia da Articulação Temporomandibular, de suas disfunções, causas e consequências, sendo capaz de distinguir a terapêutica eficiente para cada disfunção e, por fim, analisar a conduta com encaminhamentos adequados para a evolução do caso.

BACKGROUND: the balance referring to the structures and functions of the stomatognatic system depends on the appropriate functioning of the Temporomandibular Joint, and this one, needs the correct teeth occlusion for accomplishing the functional needs when moving the jaw. The muscle or structural unbalance of the Temporomandibular Joint may result in a dysfunction of this joint and cause diverse signs and symptoms such as hearing manifestations, namely: tinnitus and ear pain. PURPOSE: literature review in the areas of audiology, otolaryngology and dentistry aiming at associating them with Temporomandibular Dysfunction and show the importance of multidisciplinary activities, emphasizing the speech action in such dysfunction. CONCLUSION: many hypotheses try to explain the existent relationship among the Temporomandibular Dysfunction and hearing alterations. We verified that there is a link between the stomatognatic system and the hearing system. However, most important than just associating the stomatognatic and hearing systems, the team has been involved in the assistance to the patients, including the speech therapy professional that must have knowledge about anatomy and physiology of the Temporomandibular Joint and related disorders, causes and consequences. The said professional should be capable to distinguish the effective therapy for each disorder and evaluate the indications and contra-indications of each one, and, finally, examine the conduct with referrals being appropriate for the case evolution.