Avaliação comparativa das características craniofaciais de crianças apneicas com e sem atresia transversal da maxila

Abstract

Introduction: Obstructive sleep apnea syndrome (OSAS) is a sleep-related breathing disorder characterized by recurrent episodes of partial or total upper airway obstruction (UAV). The interrelation between craniofacial structure and the physiological function of the upper airways is essential for understanding the etiology and treatment of OSAS in children. Objective: To perform a comparative analysis between children with and without maxillary atresia who have the same degree of tonsil and adenoid hypertrophy, as a way to determine the dento-skeletal characteristics of each group. Materials and Methods: We selected 54 children (5 to 12 years old) diagnosed with apnea, with and without maxillary atresia, tonsil hypertrophy grade III or IV, and adenoid hypertrophy greater than 40%. Excluded from the study were: children who were obese; genetic syndromes; children with an age range above or below that established; craniofacial deformities. Measurements were made in two stages: Analysis of the plaster models, lower and upper, consisting of: Occlusal Ratio, Arch Length and Perimeter, Intercanine and intermolar distances and Overjet; Cephalometric tracings, angles and measurements SNA, SNB, ANB, WITS, A-NPerp, Co-A, Co-Gn, SN.GoGN, FMA, 1.NA, 1-NA, IMPA, 1.NB, 1-NB. And tabulated the data in two tables, patients with and without atresia. Statistical Analysis: A descriptive analysis was performed for each of the variables researched. Tests of normality (Shapiro-Wik) were done to evaluate the type of distribution (parametric or non-parametric). The t-student and Wilcoxon tests were adopted to verify the existence of statistical significance between the groups, with a confidence level of 0.05. Results: Statistical differences were noted in Plaster Models for the Intermolar Distances of the Maxilla and Mandible, justified by maxillary atresia, as well as the prevalence of Class II in patients with maxillary atresia; and Cephalometric Tracings for A-NPerp, FMA and IMPA measurements. Conclusion: Despite the significant statistical differences, the analyses showed similar craniofacial features for both groups, with a slightly upright facial growth pattern, suggesting that these features have little influence from maxillary atresia.