Orofacial motricity in adenotonsilectomy: a study of the optimal time for surgery

• Grant number: 17/10199-0
• Support Opportunities: Regular Research Grants
• Duration: October 01, 2017 - March 31, 2020
• Field of knowledge: Health Sciences - Speech Therapy
• Principal Investigator: Maria Fernanda Bagarollo
• Grantee: Maria Fernanda Bagarollo
• Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Introduction: The hypertrophy of palatine and pharyngeal tonsils is extremely common in children, being one of the most frequent causes of visits to otolaryngologistsand pediatricians. Such changes can cause constant oral breathing and lead children to numerous craniofacial, orthodontic, and orthognathic alterations, which may impair oral functions and compromise the quality of life of this population. The most common medical procedure used to solve the presence of hypertrophic tonsils is an elective surgery. Objectives: The general objective of this study is to analyze the immediate and long-term reactions of the adenotonsillectomy procedure in the stomatognathic system and in the muscular electric activity of children aged 3 to 12, divided by age groups submitted to surgery, as well as to compare the data to a control group of children who did not present palatine and / or pharyngeal tonsil alterations and did not undergo a medical procedure. Method: To develop this research two groups of children will be formed: a Study Group (SG) and a Control Group (CG). The SG will be comprised of 3 to 12-year-old children, who will undergo adenotonsillectomy surgery. The SG will be divided into three age subgroups, being (1) from 3 to 5 years old, (2) from 6 to 8 years old, and (3) above 9 years old. The CG will be comprised of children with no respiratory complaints and who, through otorhinolaryngological evaluation, showed no hypertrophy of palatine and pharyngeal tonsils and will not undergo any medical procedure. The control group will be paired to the SG by sex and age. The data collection procedures will be: speech-language evaluation of aspects of orofacial motricity, before and after surgery, short and long-term evaluation, surgical intervention in the SG cases. In the CG, evaluations will follow the same time intervals of the SGs, using the expanded protocol of orofacial myofunctional evaluation (E-OMES) and surface electromyography of the masseter and temporalis muscles. The data will be analyzed statistically with the use of tests selected by a professional of the area. Expected results: It is expected to understand if the surgical procedure alone is capable of promoting nasal breathing and the adjustment of the stomatognathic system and if the age group, at the moment the surgery is performed, interferes positively in the reestablishment of this system. It is expected to understand how the stomatognathic system behaves when the nasal cavity is cleared, the persistent phono-audiological changes after the surgical procedure, and the best moments for working with this population in actions of early intervention and adequate rehabilitation. It is also expected that the results achieved may contribute to the prevention of possible alterations in orofacial motricity, to establish the best moment for surgical procedure, as well as to indicate if there is an improvement in the quality of life of oral breathing children, considering cases of tonsil hypertrophy. (AU)