CoDAS
https://codas.org.br/article/doi/10.1590/2317-1782/20232022049en
CoDAS
Original Article

Association between tongue, lips position and breathing in newborns

Associação entre posição de língua, lábios e respiração em recém-nascidos

Silvia Márcia Andrade Campanha; Roberta Lopes de Castro Martinelli; Durval Batista Palhares

http://dx.doi.org/10.1590/2317-1782/20232022049en CoDAS, vol.35, n5, e20220049, 2023
PDF English
PDF Português
PDF
SciELO
Downloads: 1
Views: 406

Abstract

Purpose

To verify the association between breathing nasal expiratory flow and posture of lips and tongue at rest, presence of repeated forward movements of the tongue and maternal complaint of respiratory difficulty in the newborn in the first days of life.

Method

A observational study was carried out in 130 babies, in a university hospital. Included newborn with Apgar score greater than or equal to 8 in exclusive breast milk. It was the following data: position of lips and tongue at rest, nasal expiratory flow and maternal complaint of difficulty in breathing in the newborn. The data were subjected to statistical analysis using the tests, Fisher's exact test and the Chi-Square test, adopting a significance level of 5% .

Results

there was a significant association between maternal complaint of newborn difficulty breathing with repeated forward tongue movements and nasal expiratory flow; tongue position with resting lips position at rest, repeated tongue forward movements with nasal expiratory flow and tongue position at rest; nasal expiratory flow exit with tongue position at rest.

Conclusion

Symmetrical nasal expiratory flow is associated with an elevated tongue position and closed lips at rest; on the other hand, increased and/or absent nasal expiatory flow in one nostril is associated with maternal complaints of difficulty in breathing, open/ half-open lips position and low tongue position during rest, as well as, repeated forward tongue movements.

Keywords

Breathing; Newborn; Tongue; Nasal obstruction; Mouth breathing

Resumo

Objetivo

verificar a associação entre fluxo expiratório nasal e postura de lábios e língua no repouso, presença de movimentos repetidos de anteriorização de língua e queixa materna de dificuldade respiratória do recém-nascido nos primeiros dias de vida.

Método

estudo observacional, realizado com 130 recém-nascidos do alojamento conjunto de um hospital Universitário. Foram incluídos recém-nascidos a termo, com idade entre 1 e 5 dias de vida, APGAR maior ou igual a oito, em aleitamento materno exclusivo. Foram coletados os seguintes dados: posição de lábios e língua no repouso, fluxo expiratório nasal, presença de movimentos repetidos de anteriorização de língua e queixa materna de dificuldade do recém-nascido para respirar. Os dados foram submetidos à análise estatística, sendo aplicado o Teste Exato de Fisher e o Qui-Quadrado, adotando-se o nível de significância de 5%.

Resultados

Há uma associação significativa entre queixas maternas de dificuldade do recém-nascido para respirar pelo nariz com movimentos repetidos de anteriorização de língua e fluxo expiratório nasal; posição de língua com posição de lábios no repouso, movimentos repetidos de anteriorização de língua com fluxo expiratório nasal e posição de língua no repouso; fluxo expiratório nasal com posição de língua no repouso.

Conclusão

O fluxo expiratório nasal simétrico está associado com a posição de língua elevada e lábios fechados no REPOUSO; por outro lado, o fluxo expiratório nasal maior e/ou ausente em uma narina está associado com queixa materna de dificuldade do recém-nascido para respirar, posição de lábios abertos/entreabertos E posição de língua baixa no repouso, bem como, com movimentos repetidos de anteriorização de língua.

Palavras-chave

Respiração; Recém-nascido; Língua; Obstrução Nasal; Respiração Bucal

Referencias

  1. Frank S, Schoem SR. Nasal obstruction in the infant. Pediatr Clin North Am. 2022;69(2):287-300. http://dx.doi.org/10.1016/j.pcl.2021.12.002 PMid:35337540.
  2. Geddes DT, Gridneva Z, Perrella SL, Mitoulas LR, Kent JC, Stinson LF, et al. 25 years of research in human lactation: from discovery to translation. Nutrients. 2021;13(9):3071. http://dx.doi.org/10.3390/nu13093071 PMid:34578947.
  3. Walker M. Breastfeeding management for the clinician: using the evidence. Massachusetts: Jones and Bartlett; 2011.
  4. Smith MM, Ishman SL. Pediatric nasal obstruction. Otolaryngol Clin North Am. 2018;51(5):971-85. http://dx.doi.org/10.1016/j.otc.2018.05.005 PMid:30031550.
  5. Alvo A, Villarroel G, Sedano C. Neonatal nasal obstruction. Eur Arch Otorhinolaryngol. 2021;278(10):3605-11. http://dx.doi.org/10.1007/s00405-020-06546-y PMid:33388986.
  6. Hermann JS, Sakai APC, Hermann DR, Pignatari SSN. Nasal obstruction with emphasis on higienization. Pediatr Mod. 2013;49(7):249-62.
  7. Aykanat A, Çelik HT, Günaydın RÖ, Yiğit Ş. Iatrogenic nasal synechiae in a premature newborn. Turk J Pediatr. 2020;62(3):505-8. http://dx.doi.org/10.24953/turkjped.2020.03.023 PMid:32558430.
  8. Silva LK, Brasolotto AG, Berretin-Felix G. Função respiratória em indivíduos com deformidades dentofaciais. Rev CEFAC. 2015;17(3):854-63. http://dx.doi.org/10.1590/1982-0216201513314
  9. Melo DL, Santos RV, Perilo TV, Becker HM, Motta AR. Mouth breathing evaluation: use of Glatzel mirror and peak nasal inspiratory flow. CoDAS. 2013;25(3):236-41. http://dx.doi.org/10.1590/S2317-17822013000300008 PMid:24408334.
  10. Price A, Eccles R. Is there any relationship between right and left hand dominance and right and left nasal airflow dominance? J Laryngol Otol. 2017;131(10):846-52. http://dx.doi.org/10.1017/S0022215117001475 PMid:28768555.
  11. Williams MR, Eccles R. A simple, quick, validated method of recording the nasal cycle in humans using a subjective scale. J Laryngol Otol. 2018;132(12):1067-71. http://dx.doi.org/10.1017/S0022215118001974 PMid:30442215.
  12. Cunha RA, Cunha DA, Bezerra LA, Melo ACC, Peixoto DM, Tashiro T, et al. Nasal aeration and respiratory muscle strength in mouth breathers’ children. Rev CEFAC. 2015;17(5):1432-40. http://dx.doi.org/10.1590/1982-021620151753315
  13. Bassi IB, Motta AR, Franco LP. Eficácia do emprego do espelho de Glatzel na avaliação da permeabilidade nasal. Rev Soc Bras Fonoaudiol. 2009;14(3):367-17. http://dx.doi.org/10.1590/S1516-80342009000300013
  14. Martinelli RLC, Marchesan IQ, Berretin-Felix G. Rest Position of the Tongue in Infants with and without Lingual Frenulum Alteration. Int J Orofacial Myology. 2016;42(1):43-8. http://dx.doi.org/10.52010/ijom.2016.42.1.5
  15. Campanha SMA, Martinelli RLC, Palhares DB. Position of lips and tongue in rest in newborns with and without ankyloglossia. CoDAS. 2021;33(6):e20200069. http://dx.doi.org/10.1590/2317-1782/20202020069 PMid:34190809.
  16. Campanha SMA, Martinelli RLC, Palhares DB. Anthropometric orofacial measures of newborns and their relationship with sex, weight and height. CoDAS. 2022;34(1):e20200114. http://dx.doi.org/10.1590/2317-1782/20212020114 PMid:35019062.
  17. Musseau D. Mouth breathing and some of its consequences. Int J Orthod Milwaukee. 2016;27(2):51-4. PMid:29799704.
  18. Fonseca CSBM, March MFP, Sant’Anna CC. Mouth breathing and craniofacial alterations in students aged 8 to 10 years. Arq Asma Alerg Imunol. 2017;1(4):395-402.
  19. Oliven R, Cohen G, Somri M, Schwartz AR, Oliven A. Relationship between the activity of the genioglossus, other peri-pharyngeal muscles and flow mechanics during wakefulness and sleep in patients with OSA and healthy subjects. Respir Physiol Neurobiol. 2020;274:103362. http://dx.doi.org/10.1016/j.resp.2019.103362 PMid:31866501.
  20. Fregosi RF, Ludlow CL. Activation of upper airway muscles during breathing and swallowing. J Appl Physiol (1985). 2014;116(3):291-301. http://dx.doi.org/10.1152/japplphysiol.00670.2013 PMid:24092695.
  21. Mediano O, Romero-Peralta S, Resano P, Cano-Pumarega I, Sánchez-de-la-Torre M, Castillo-García M, et al. Obstructive sleep apnea: emerging treatments targeting the genioglossus muscle. J Clin Med. 2019;8(10):1754. http://dx.doi.org/10.3390/jcm8101754 PMid:31652594.
  22. Bailey EF, Fregosi RF. Coordination of intrinsic and extrinsic tongue muscles during spontaneous breathing in the rat. J Appl Physiol (1985). 2004;96(2):440-9. http://dx.doi.org/10.1152/japplphysiol.00733.2003 PMid:14527967.
  23. Avraam J, Dawson A, Feast N, Fan FL, Fridgant MD, Kay A, et al. After-discharge in the upper airway muscle genioglossus following brief hypoxia. Sleep. 2021;44(9):zsab084. http://dx.doi.org/10.1093/sleep/zsab084 PMid:33822200.
  24. Williams JS, Janssen PL, Fuller DD, Fregosi RF. Influence of posture and breathing route on neural drive to upper airway dilator muscles during exercise. J Appl Physiol (1985). 2000;89(2):590-8. http://dx.doi.org/10.1152/jappl.2000.89.2.590 PMid:10926642.
  25. Luu BL, Saboisky JP, McBain RA, Trinder JA, White DP, Taylor JL, et al. Genioglossus motor unit activity in supine and upright postures in obstructive sleep apnea. Sleep. 2020;43(6):zsz316. http://dx.doi.org/10.1093/sleep/zsz316 PMid:31875918.
  26. Guilleminault C, Huseni S, Lo L. A frequent phenotype for paediatric sleep apnoea: short lingual frenulum. ERJ Open Res. 2016;2(3):00043-02016. http://dx.doi.org/10.1183/23120541.00043-2016 PMid:27730205.
     
65a86841a953954db621dbc5 codas Articles
2317-1782 (Electrónico)
CoDAS ©2024 Todos los derechos reservados.

CoDAS

Share this page
Page Sections