Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 24
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
J Pediatr (Rio J) ; 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31758916

RESUMO

OBJECTIVES: To assess the presence of restless legs syndrome, periodic leg movement, and sleep disorders in female adolescents with idiopathic musculoskeletal pain through a sleep scale and polysomnography, and to compare these data in adolescents without pain history. METHOD: Twenty-six adolescents diagnosed with idiopathic musculoskeletal pain followed in a pain outpatient clinic and 25 healthy controls matched by age and education were recruited. The restless legs syndrome criteria were evaluated according to the International Restless Legs Syndrome Study Group, the Sleep Disturbance Scale for Children was completed, nocturnal polysomnography was performed, and anxiety symptoms were recorded. RESULTS: The mean age of idiopathic musculoskeletal pain adolescents was 13.9±1.6 years; in controls, it was 14.4±1.4 years. One adolescent in the control group (4 %) and nine patients with idiopathic musculoskeletal pain (34.6 %) fulfilled the restless legs syndrome criteria (p=0.011). The authors did not observe significant differences in Sleep Disturbance Scale for Children scores between the groups in all components: disorders of initiating and maintaining sleep (p=0.290), sleep breathing disorders (p=0.576), disorders of arousal (p=0.162), sleep-wake transition disorders (p=0.258), disorder of excessive daytime somnolence (p=0.594), and sleep hyperhidrosis (p=0.797). The neurophysiological, respiratory, and periodic leg movement parameters were similar in both groups. Having anxiety was not associated with restless legs syndrome (p=0.11). Three patients with idiopathic musculoskeletal pain (11.5 %) presented restless legs syndrome and periodic leg movement simultaneously, which was absent in the control group. CONCLUSION: Female adolescents with idiopathic musculoskeletal pain present criteria for RLS more frequently than healthy adolescents. However, this study did not observe relevant changes in objective and subject sleep variables.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32008915

RESUMO

BACKGROUND AND AIMS: Pediatric obesity and sleep-disordered breathing (SDB) are associated with cardiometabolic risk (CMR), but the degree of severity at which SDB affects cardiometabolic health is unknown. We assessed the relationship between the CMR and the apnea-hypopnea index (AHI), to identify a threshold of AHI from which an increase in the CMR is observed, in adolescents with obesity. We also compared the clinical, cardiometabolic and sleep characteristics between adolescents presenting a high (CMR+) and low CMR (CMR-), according to the threshold of AHI. METHODS AND RESULTS: 114 adolescents with obesity were recruited from three institutions specialized in obesity management. Sleep and SDB as assessed by polysomnography, anthropometric parameters, fat mass (FM), glucose and lipid profiles, and blood pressure (BP) were measured at admission. Continuous (MetScoreFM) and dichotomous (metabolic syndrome, MetS) CMR were determined. Associations between MetScoreFM and AHI adjusted for BMI, sex and age were assessed by multivariable analyses. Data of 82 adolescents were analyzed. Multivariable analyses enabled us to identify a threshold of AHI = 2 above which we observed a strong and significant association between CMR and AHI (Cohen's d effect-size = 0.57 [0.11; 1.02] p = 0.02). Adolescents with CMR+ exhibited higher MetScoreFM (p < 0.05), insulin resistance (p < 0.05), systolic BP (p < 0.001), sleep fragmentation (p < 0.01) and intermittent hypoxia than CMR- group (p < 0.0001). MetS was found in 90.9% of adolescents with CMR+, versus 69.4% in the CMR- group (p < 0.05). CONCLUSIONS: The identification of a threshold of AHI ≥ 2 corresponding to the cardiometabolic alterations highlights the need for the early management of SDB and obesity in adolescents, to prevent cardiometabolic diseases. CLINICAL TRIALS: NCT03466359, NCT02588469 and NCT01358773.

3.
Pediatr Endocrinol Rev ; 16(2): 266-274, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30556659

RESUMO

Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness, cataplexy, sleep paralysis and hypnagogic and hypnopompic hallucinations. The onset of the symptoms usually occurs in childhood, and previous studies have reported an association between narcolepsy and other endocrine diseases in the pediatric population, such as obesity and precocious puberty. The incidence of overweight or obesity ranges from 25% to 74% in patients with narcolepsy type I, while precocious puberty is present in 17% of children with narcolepsy with cataplexy. However, the mechanisms involved in the association of narcolepsy with obesity and precocious puberty have not been fully elucidated yet. In this review, we aimed to discuss narcolepsy in pediatric populations, highlighting the diagnostic difficulties and the complexity of the possible mechanisms that can relate narcolepsy to precocious puberty and obesity. We also emphasized the fact that endocrine diseases must be taken into consideration in children diagnosed with narcolepsy.


Assuntos
Cataplexia , Narcolepsia , Puberdade Precoce , Criança , Humanos , Obesidade
5.
Sleep Sci ; 10(1): 1-6, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28966731

RESUMO

INTRODUCTION: Obesity is a factor that is strongly related to the occurrence of obstructive sleep apnea (OSA) in adults, although this association remains controversial for children. OBJECTIVE: The aim of this study was to compare the clinical and upper airway charactheristics, obtained by questionnaires, physical examination and laboratory tests, among obese children with and without OSA. METHOD: This was aprospective cohort study. 44 obese children (body mass index above the 95th percentile) were included in the study. Questionnaires, physical examination of the upper airway, nasofibrolaryngoscopy, polysomnography, and laboratory allergic tests were performed. RESULTS: There were 22 male patients (50%), and the mean age was 7.6±2.5 years. OSA was present in 19 (43%) patients. There were no statistically significant differences between the groups with and without OSA, in relation to clinical or laboratory allergic parameters. For the upper airway assessments, hypertrophy of the pharyngeal (p=0.001) and palatine (p=0.049) tonsils were the only parameters associated with OSA, and a modified Mallampati index of class III/IV also demonstrated a tendency towards being statistically associated with OSA (p=0.081). Moreover, these findings were confirmed to be factors associated with OSA in this group of children according to a logistic regression analysis. CONCLUSIONS: The occurrence rate of OSA in this obese pediatric population was high. Adenotonsillar hypertrophy and a modified Mallampati index of class III/IV were the factors associated with OSA.

6.
Sleep Breath ; 20(1): 129-34, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26003786

RESUMO

BACKGROUND: Sleep disturbance is a common problem for caregivers. In general, patients with Duchenne muscular dystrophy (DMD) use noninvasive ventilation to maintain quality of life and improve survival. OBJECTIVE: The aim of this study was to evaluate the sleep quality of caregiver-mothers of sons with DMD and factors that are associated with their sleep quality. METHODS: We evaluated 32 caregiver-mothers of sons with DMD and 32 mothers of sons without any neuromuscular or chronic disease (control-CTRL group). The evaluation of quality of sleep was made using the Pittsburgh Sleep Quality Index (PSQI). RESULTS: Caregiver-mothers had poor sleep quality, specifically longer sleep latency and reduced sleep efficiency. The impaired sleep quality of the caregiver-mothers was associated with the length of time of noninvasive ventilation used by their sons. CONCLUSIONS: Our results suggest that caregiver-mothers of sons with DMD have poor quality of sleep, and the length of use of noninvasive ventilation of their sons is associated with better sleep of caregiver-mothers.


Assuntos
Cuidadores , Efeitos Psicossociais da Doença , Assistência Domiciliar , Mães , Distrofia Muscular de Duchenne/enfermagem , Ventilação não Invasiva/enfermagem , Transtornos do Sono-Vigília/etiologia , Adolescente , Adulto , Brasil , Estudos de Casos e Controles , Feminino , Humanos , Pessoa de Meia-Idade , Valores de Referência , Cadeiras de Rodas , Adulto Jovem
7.
Nutrition ; 32(3): 391-3, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26701140

RESUMO

Duchenne muscular dystrophy (DMD) is the second most common hereditary genetic disease in humans and has elevated mortality. DMD is an X-linked, life-limiting progressive muscle-wasting disease found predominantly in boys and young men. One of the main treatments for patients with DMD is corticosteroids. However, long-term use may cause major side effects such as obesity, a reduction in vitamin D, and osteoporosis. Sleep-disordered breathing is a common condition among patients with DMD, especially obstructive sleep apnea (OSA). In children, OSA is associated with obesity and a reduction of vitamin D concentration. In this article we aim to explore the interrelationship that exists between corticosteroids, obesity, OSA, and the risk of osteoporosis. Our main hypothesis is that factors such as nutrition and sleep are related to obesity and OSA, respectively. In addition, the chronic use of corticosteroids, obesity, and OSA are factors that can reduce serum levels of vitamin D, triggering osteoporosis. Thus, these factors play a key role in affecting the quality of life for patients with DMD and intervention based on these aspects may improve survival.


Assuntos
Corticosteroides/administração & dosagem , Corticosteroides/efeitos adversos , Distrofia Muscular de Duchenne/tratamento farmacológico , Estado Nutricional , Transtornos do Sono-Vigília/sangue , Adolescente , Criança , Pré-Escolar , Humanos , Masculino , Distrofia Muscular de Duchenne/complicações , Distrofia Muscular de Duchenne/genética , Obesidade/sangue , Osteoporose/sangue , Qualidade de Vida , Síndromes da Apneia do Sono/sangue , Vitamina D/sangue , Deficiência de Vitamina D/sangue
8.
Sleep Sci ; 9(3): 129-133, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28123647

RESUMO

We discussed two cases of symptomatic female carriers to Duchenne Muscular Dystrophy. The first case is a 20 year-old girl with classical phenotypic manifestation of the disease, similar to the condition in boys. The case 2 is a 62 year-old woman with progressive muscular weakness. The disease is much less common in woman than men so both cases described here are considered rare forms of the disease, with several clinical implications. In both cases, a progressive muscle weakness, impairment in walking and sleeping was observed, in addition to obstructive sleep apnea syndrome and alveolar hypoventilation, that required noninvasive ventilatory support.

11.
Sex Med ; 2(3): 133-40, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25356310

RESUMO

INTRODUCTION: The task of the caregiver, especially a caregiving mother of a son with a chronic and fatal disease, may interfere with their quality of sleep, sexuality, and some hormone levels. AIM: The aim of this study was to evaluate the sexual function and the quality of sleep of caregiving mothers of sons with Duchenne muscular dystrophy (DMD). METHODS: We evaluated 20 caregiving mothers of sons with DMD and 20 caregiving mothers of sons without any neuromuscular or chronic disease. All of them voluntarily responded to the evaluating questionnaires about their sexuality and their quality of sleep, and gave blood samples to evaluate their hormonal levels. MAIN OUTCOME MEASURES: All mothers were evaluated using the questionnaire of Female Sexual Function Index (FSFI) and the Pittsburgh questionnaire (PSQI). The blood samples were tested to determine serum levels of testosterone, estradiol, follicle-stimulating hormone, luteinizing hormone, progesterone, adrenocorticotropic hormone, and cortisol. RESULTS: Caregiving mothers of sons with DMD had significantly lower scores in the FSFI questionnaire, suggesting a higher risk for sexual dysfunction. The PSQI demonstrated that these caregiving mothers present increased sleep latency, reduced sleep efficiency, daytime dysfunction, and poor sleep quality. Blood tests showed a rise in cortisol levels, which correlated with the compromised sexuality and quality of sleep. CONCLUSIONS: This study indicates that caregiving mothers of sons with DMD show major risk for sexual dysfunction and a reduction in their quality of sleep mediated in part by the hormonal changes related to stress. Nozoe KT, Hachul H, Hirotsu C, Polesel DN, Moreira GA, Tufik S, and Andersen ML. The relationship between sexual function and quality of sleep in caregiving mothers of sons with Duchenne muscular dystrophy. Sex Med 2014;2:133-140.

12.
Sleep Breath ; 18(4): 791-7, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24705807

RESUMO

PURPOSE: Mucopolysaccharidosis (MPS) encompasses a group of rare lysosomal storage disorders that are associated with the accumulation of glycosaminoglycans in organs and tissues. Respiratory disorders occur in all MPS types. In these patients, the prevalence of obstructive sleep apnea syndrome (OSAS), which may confer additional morbidity, remains overlooked, and the results of the few existing studies are controversial. The present study aimed to characterize the prevalence of OSAS in patients with MPS types I, II, and VI in a reference center. METHODS: Forty-five patients with MPS (I, n=17; II, n=16; and VI; n=12) in the Centro de Referência em Erros Inatos do Metabolismo, who underwent full-night polysomnography, were enrolled in a retrospective study. Demographic data and clinical history were collected from medical records of the first medical consultation. RESULTS: The prevalence of OSAS in patients with MPS was 69.8%. MPS type I patients seemed to be more susceptible to OSA-induced hypoxemia, as indicated by reduced mean SpO2 levels during both NREM and rapid eye movement sleep as well as during SpO2 nadir. CONCLUSIONS: Patients with MPS displayed a high prevalence of OSAS, often with moderate to high severity. Together, our results reinforce the need for OSAS screening in all patients with MPS.


Assuntos
Mucopolissacaridose II/epidemiologia , Mucopolissacaridose I/epidemiologia , Mucopolissacaridose VI/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Adolescente , Brasil , Criança , Pré-Escolar , Comorbidade , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Mucopolissacaridose I/diagnóstico , Mucopolissacaridose II/diagnóstico , Mucopolissacaridose VI/diagnóstico , Polissonografia , Estudos Retrospectivos , Apneia Obstrutiva do Sono/diagnóstico , Adulto Jovem
15.
São Paulo; SES/SP; 2008. 122 p. ilus, tab, graf.
Monografia em Português | LILACS, Coleciona SUS, SESSP-CTDPROD, Sec. Est. Saúde SP, SESSP-ACVSES, SESSP-CVEPROD, Sec. Est. Saúde SP | ID: biblio-933379

RESUMO

As doenças neuromusculares representam um grupo de afecções que comprometem a unidade motora, ou seja, o corpo celular do neurônio motor inferior, o seu prolongamento, a junção neuromuscular ou o tecido muscular. Dentre as doenças neuromusculares, encontram-se as lesões neuronais motoras, que são condições nas quais há alterações morfológicas ou bioquímicas que ocorrem no corpo do neurônio. A lesão neuronal motora caracteriza-se por envolvimento do corpo celular do neurônio motor inferior (NMI). As principais doenças são: poliomielite anterior aguda (Pólio), atrofia muscular espinhal progressiva (AMEP) e doença do neurônio motor (DNM). A síndrome pós-poliomielite(SPP)é um transtorno neurológico, denro do capítulo dos efeitos tardios da poliomielite, caracterizados por nova fraqueza muscular e/ou fadiga muscular anormal em indivíduos que tiveram poliomielite aguda, muitos anos antes. A SPP encontra-se na categoria das doenças do nerônio motor (neuronopatia motora) em virtude dos quadros clínico e histológico estarem intimamente relacionados com disfunção dos neurônios motores inferiores.


Assuntos
Síndrome Pós-Poliomielite/diagnóstico , Síndrome Pós-Poliomielite/terapia
16.
São Paulo; SES/SP; 2008. 122 p. ilus, tab, graf.
Monografia em Português | Sec. Est. Saúde SP, SESSP-CTDPROD, Sec. Est. Saúde SP, SESSP-ACVSES, SESSP-CVEPROD, Sec. Est. Saúde SP, SESSP-IPACERVO | ID: ses-8566

RESUMO

As doenças neuromusculares representam um grupo de afecções que comprometem a unidade motora, ou seja, o corpo celular do neurônio motor inferior, o seu prolongamento, a junção neuromuscular ou o tecido muscular. Dentre as doenças neuromusculares, encontram-se as lesões neuronais motoras, que são condições nas quais há alterações morfológicas ou bioquímicas que ocorrem no corpo do neurônio. A lesão neuronal motora caracteriza-se por envolvimento do corpo celular do neurônio motor inferior (NMI). As principais doenças são: poliomielite anterior aguda (Pólio), atrofia muscular espinhal progressiva (AMEP) e doença do neurônio motor (DNM). A síndrome pós-poliomielite(SPP)é um transtorno neurológico, denro do capítulo dos efeitos tardios da poliomielite, caracterizados por nova fraqueza muscular e/ou fadiga muscular anormal em indivíduos que tiveram poliomielite aguda, muitos anos antes. A SPP encontra-se na categoria das doenças do nerônio motor (neuronopatia motora) em virtude dos quadros clínico e histológico estarem intimamente relacionados com disfunção dos neurônios motores inferiores. (AU)


Assuntos
Síndrome Pós-Poliomielite/diagnóstico , Síndrome Pós-Poliomielite/terapia
17.
Braz J Otorhinolaryngol ; 72(3): 321-7, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17119766

RESUMO

INTRODUCTION: The obstructive sleep apnea syndrome (OSAS) is a respiratory disorder that occurs during sleep and it is relatively common in children. AIM: The goal of this paper is to verify if there is a relationship between the obstructive sleep apnea syndrome (OSAS) and auditory processing. METHODS: In order to do that, three groups of children ranging in age from 5 to 11 were studied, including a normal group. Twenty subjects who made up the study group were submitted to ear, nose and throat (ENT) exams and to polysomnography (PSG), and were divided in two groups: GROUP I (RO) comprised of 10 children who presented oral breathing and displayed normal PSG, and GROUP II (SAS) comprised of 10 children who presented oral breathing and displayed abnormal PSG. Their performance was compared to the performance of the third group--GROUP III (REN) comprised of 10 children who did not refer ENT difficulties. All the subjects completed a basic audiometric assessment as well as an auditory processing diagnosis. RESULTS: The analyses of the results revealed a statistically significant difference in ENT exams related to the turbinate and the palatine tonsils. Group II presented a higher incidence of turbinate hypertrophy levels II and III (p<0.001) and palatine tonsils hypertrophy grades III and IV (p 0.007). Regarding the auditory processing assessment, a statistically significant difference (p<0.001) was obtained in the dichotic digits test. Group II performed worse than group III. Also, for the non-verbal sequence memory test, Group II obtained a worse result (p<0.022) than Group I. CONCLUSION: Subjects with OSAS obtained worse results in auditory processing tests.


Assuntos
Transtornos da Percepção Auditiva/etiologia , Apneia Obstrutiva do Sono/complicações , Audiometria , Transtornos da Percepção Auditiva/diagnóstico , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Testes Auditivos , Humanos , Hipertrofia , Masculino , Tonsila Palatina/patologia , Polissonografia , Índice de Gravidade de Doença , Conchas Nasais/patologia
18.
Braz J Otorhinolaryngol ; 72(2): 187-92, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16951851

RESUMO

UNLABELLED: Polysomnography is the goldstandard exam for child OSAS. When possible, polysomnography clearly distinguishes between those with isolated primary snoring and patients with sleep apnea (obstructive, central and mixed). The most common cause of OSAS in childhood is adenotonsillar hypertrophy. Laryngomalacia is the most common cause of stridor in childhood, though its physiopathology remains unknown. Among the most prominent theories are immaturity of the cartilaginous framework of the larynx and/or neuromuscular immaturity. OBJECTIVE: Our proposal was to describe polysomnographic findings in children with laryngomalacia or other isolated laryngeal alterations, that is, without other alterations in the upper airways. METHODS: The sample included 29 children with exclusively laryngeal alterations. All of them underwent an otorhinolaryngological exam, nasofibrolaryngoscopy and polysomnography. Information was recorded concerning age, nasofibrolaryngoscopy and polysomnography. For analysis, the children were divided into two groups: those with laryngomalacia and those with other laryngeal diseases. RESULTS: Among the 18 children with a diagnosis of laryngomalacia, 18 had central breathing events, knowing that the majority had showed desaturation of oxihemoglobin and bradycardia. In this same group, 3 children had obstructive events. On the other hand, 11 children with other laryngeal alterations showed no predominance of one type or another of apnea. Of these, 4 had central type breathing events and 2 obstructive type. CONCLUSION: The majority of patients with laryngomalacia showed a central type apnea. Patients with various laryngeal diseases did not present a predominant type of apnea.


Assuntos
Doenças da Laringe/complicações , Síndromes da Apneia do Sono/etiologia , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Polissonografia , Síndromes da Apneia do Sono/diagnóstico
19.
Rev. bras. otorrinolaringol ; 72(3): 321-327, maio-jun. 2006. tab
Artigo em Português, Inglês | LILACS | ID: lil-436282

RESUMO

INTRODUÇÃO: síndrome da apnéia/hipopnéia obstrutiva do sono (SAHOS) é uma desordem de respiração durante o sono e tem sido descrita como uma condição relativamente comum em crianças. OBJETIVO: Verificar se existe relação entre a presença da Síndrome da Apnéia/Hipopnéia Obstrutiva do Sono e alteração de processamento auditivo. MÉTODOS: Foram avaliados 3 grupos de crianças na faixa etária de 5 a 11 anos, incluindo um grupo controle. Vinte indivíduos que constituíram o grupo de estudo foram submetidos à avaliação otorrinolaringológica e ao exame de polissonografia (PSG) e foram divididos em dois grupos: Grupo I (RO) constituído por 10 indivíduos respiradores orais e PSG normal e Grupo II (SAS) constituído por 10 indivíduos respiradores orais e PSG alterado. O desempenho destes indivíduos foi comparado a um terceiro grupo - Grupo III (REN) composto de 10 crianças sem queixas otorrinolaringológicas. Todos os sujeitos foram submetidos à avaliação audiológica básica e à avaliação do PA. RESULTADOS: Quanto à avaliação otorrinolaringológica, houve diferença estatisticamente significante no que se refere à avaliação dos cornetos nasais e das tonsilas palatinas. No grupo II, verificou-se maior número de indivíduos com hipertrofia de cornetos nasais grau II e III (p < 0,001) e com hipertrofia de tonsila palatina grau III e IV (p 0,007). Em relação à avaliação de PA, os resultados mostraram que houve diferença estatisticamente significante (p < 0,001) no teste dicótico de dígitos, tendo o grupo II apresentado pior desempenho do que o grupo III e, no resultado do teste de memória para sons não-verbais em seqüência (p < 0,022), tendo o grupo II apresentado pior desempenho do que o grupo I. CONCLUSÃO: A presença da SAHOS relacionou-se positivamente com a alteração de processamento auditivo.


INTRODUCTION: The obstructive sleep apnea syndrome (OSAS) is a respiratory disorder that occurs during sleep and it is relatively common in children. AIM: The goal of this paper is to verify if there is a relationship between the obstructive sleep apnea syndrome (OSAS) and auditory processing. METHOD: In order to do that, three groups of children ranging in age from 5 to 11 were studied, including a normal group. Twenty subjects who made up the study group were submitted to ear, nose and throat (ENT) exams and to polysomnography (PSG), and were divided in two groups: GROUP I (RO) comprised of 10 children who presented oral breathing and displayed normal PSG, and GROUP II (SAS) comprised of 10 children who presented oral breathing and displayed abnormal PSG. Their performance was compared to the performance of the third group - GROUP III (REN) comprised of 10 children who did not refer ENT difficulties. All the subjects completed a basic audiometric assessment as well as an auditory processing diagnosis. RESULTS: The analyses of the results revealed a statistically significant difference in ENT exams related to the turbinate and the palatine tonsils. Group II presented a higher incidence of turbinate hypertrophy levels II and III (p < 0.001) and palatine tonsils hypertrophy grades III and IV (p 0.007). Regarding the auditory processing assessment, a statistically significant difference (p < 0.001) was obtained in the dichotic digits test. Group II performed worse than group III. Also, for the non-verbal sequence memory test, Group II obtained a worse result (p < 0.022) than Group I. CONCLUSIONS: Subjects with OSAS obtained worse results in auditory processing tests.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Apneia Obstrutiva do Sono/complicações , Transtornos da Percepção Auditiva/etiologia , Audiometria , Estudos de Casos e Controles , Testes Auditivos , Hipertrofia , Polissonografia , Índice de Gravidade de Doença , Conchas Nasais , Tonsila Palatina/patologia , Transtornos da Percepção Auditiva/diagnóstico
20.
Rev. bras. otorrinolaringol ; 72(2): 187-192, mar.-abr. 2006. tab
Artigo em Português | LILACS | ID: lil-434180

RESUMO

O exame diagnóstico padrão-ouro para SAOS na infância é a polissonografia. Quando pode ser efetuado, a polissonografia separa com clareza portadores de ronco primário de pacientes com apnéia (obstrutiva, central e mista) do sono. A causa mais freqüente da SAOS na infância é a hipertrofia adenoamigdaliana. Laringomalácia é a causa mais comum de estridor na infância, porém sua fisiopatologia permanece desconhecida. Entre as teorias mais aceitas estão a imaturidade do arcabouço cartilaginoso da laringe e/ou a imaturidade neuromuscular. OBJETIVO: Nossa proposta foi descrever os achados polissonográficos de crianças portadoras de laringomalácia e outras alterações laríngeas isoladas, ou seja, sem alterações nas vias aéreas superiores. MÉTODOS: Foram selecionadas 29 crianças portadoras de alterações laríngeas exclusivas. Todas foram submetidas a exame otorrinolaringológico, nasofibrolaringoscopia e polissonografia. Foram tabulados dados relativos à idade, nasofibrolaringoscopia e polissonografia. Para análise, as crianças foram separadas em 2 grupos: portadores de laringomalácia e portadores de outras doenças laríngeas. RESULTADOS: Dentre as 18 crianças com diagnóstico de laringomalácia, 18 apresentaram eventos respiratórios do tipo central, sendo a maioria dos episódios associados à dessaturação de oxigênio e alguns à bradicardia. Nesse mesmo grupo, 3 crianças apresentaram apnéia do tipo obstrutivo. Por outro lado, as 11 crianças portadoras de outras alterações laríngeas não apresentaram predominância entre um tipo ou outro de apnéia, 4 apresentaram eventos respiratórios do tipo central, 2 do tipo obstrutivo. CONCLUSÃO: A maioria dos pacientes acometidos por laringomalácia apresentou eventos respiratórios do tipo central quando avaliados pela polissonografia. Já os pacientes com outras doenças laríngeas não apresentaram predominância entre um tipo ou outro de apnéia.


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Doenças da Laringe/complicações , Síndromes da Apneia do Sono/etiologia , Polissonografia , Síndromes da Apneia do Sono/diagnóstico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA