Editorial
Establishment of nasal breathing should be the ultimate goal to secure adequate craniofacial and airway development in children
O estabelecimento da respiração nasal deve ser o objetivo final para garantir desenvolvimento craniofacial e respiratório adequados em crianças
Read
3532
Timeswas read the article
1411
Total PDF
2121
Total HTML
Share statistics
array:24 [ "pii" => "S0021755717308318" "issn" => "00217557" "doi" => "10.1016/j.jped.2017.08.002" "estado" => "S300" "fechaPublicacion" => "2018-03-01" "aid" => "557" "copyrightAnyo" => "2017" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "J Pediatr (Rio J). 2018;94:101-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1077 "formatos" => array:3 [ "EPUB" => 96 "HTML" => 701 "PDF" => 280 ] ] "Traduccion" => array:1 [ "pt" => array:19 [ "pii" => "S2255553617301313" "issn" => "22555536" "doi" => "10.1016/j.jpedp.2017.09.017" "estado" => "S300" "fechaPublicacion" => "2018-03-01" "aid" => "557" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "J Pediatr (Rio J). 2018;94:101-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1228 "formatos" => array:3 [ "EPUB" => 140 "HTML" => 791 "PDF" => 297 ] ] "pt" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Establishment of nasal breathing should be the ultimate goal to secure adequate craniofacial and airway development in children" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "101" "paginaFinal" => "103" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "O estabelecimento da respiração nasal deve ser o objetivo final para garantir desenvolvimento craniofacial e respiratório adequados em crianças" ] ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carlos Torre, Christian Guilleminault" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Carlos" "apellidos" => "Torre" ] 1 => array:2 [ "nombre" => "Christian" "apellidos" => "Guilleminault" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0021755717308318" "doi" => "10.1016/j.jped.2017.08.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755717308318?idApp=UINPBA000049" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553617301313?idApp=UINPBA000049" "url" => "/22555536/0000009400000002/v1_201803200424/S2255553617301313/v1_201803200424/pt/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S0021755716301929" "issn" => "00217557" "doi" => "10.1016/j.jped.2017.06.013" "estado" => "S300" "fechaPublicacion" => "2018-03-01" "aid" => "559" "copyright" => "Sociedade Brasileira de Pediatria" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "rev" "cita" => "J Pediatr (Rio J). 2018;94:104-22" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 965 "formatos" => array:3 [ "EPUB" => 105 "HTML" => 553 "PDF" => 307 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review article</span>" "titulo" => "Factors associated with breastfeeding maintenance for 12 months or more: a systematic review" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "104" "paginaFinal" => "122" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Fatores associados à manutenção da amamentação por 12 meses ou mais: revisão sistemática" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1919 "Ancho" => 3333 "Tamanyo" => 779993 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Hierarchical theoretical model of the variables evaluated for possible association with maintenance of breastfeeding for ≥12 months of age. <span class="elsevierStyleSup">a</span>Variable (number of evaluations of the association with outcome/number of associations with outcome).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Géssica S. Santana, Elsa Regina J. Giugliani, Tatiana de O. Vieira, Graciete O. Vieira" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Géssica S." "apellidos" => "Santana" ] 1 => array:2 [ "nombre" => "Elsa Regina J." "apellidos" => "Giugliani" ] 2 => array:2 [ "nombre" => "Tatiana de O." "apellidos" => "Vieira" ] 3 => array:2 [ "nombre" => "Graciete O." "apellidos" => "Vieira" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2255553617301374" "doi" => "10.1016/j.jpedp.2017.09.023" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553617301374?idApp=UINPBA000049" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755716301929?idApp=UINPBA000049" "url" => "/00217557/0000009400000002/v2_202011190930/S0021755716301929/v2_202011190930/en/main.assets" ] "asociados" => array:1 [ 0 => array:20 [ "pii" => "S0021755717300116" "issn" => "00217557" "doi" => "10.1016/j.jped.2017.05.007" "estado" => "S300" "fechaPublicacion" => "2018-03-01" "aid" => "535" "copyright" => "Sociedade Brasileira de Pediatria" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "J Pediatr (Rio J). 2018;94:123-30" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1837 "formatos" => array:3 [ "EPUB" => 126 "HTML" => 1375 "PDF" => 336 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Breathing mode influence on craniofacial development and head posture" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "123" "paginaFinal" => "130" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Influência do modo de respiração sobre o desenvolvimento craniofacial a e postura da cabeça" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1501 "Ancho" => 1583 "Tamanyo" => 183087 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Cephalometric landmarks, angles, and reference planes. Growth pattern: <span class="elsevierStyleBold">1. FP-MP</span> Angle formed by facial plane (N-Pg) and mandibular plane (Gn-Go). Facial plane is formed by nasion (N) and pgonion (Pg). Mandibular plane is formed by gnation (Gn) and gonion (Go); facial height: <span class="elsevierStyleBold">2. FCNA</span> Angle formed by facial center point (FC) and line FC-nasion (N) and line FC-subspinale (A); <span class="elsevierStyleBold">3. Xi-ANS-Pm</span> Angle formed by center of the ramus point (Xi) and line Xi-anterior nasal spine (ANS) and Xi-suprapogonion (Pm); Maxilla: <span class="elsevierStyleBold">4. SNA</span> Angle formed by skull base line (SN) and line N-subspinale (A). Skull base is a plane from sella (S) to nasion (N); <span class="elsevierStyleBold">5. ANS-PNS</span> Distance from anterior nasal spine (ANS) to posterior nasal spine (PNS); <span class="elsevierStyleBold">6. ANS-PNS-FhP</span> Angle formed by palatal plane (ANS-PNS) and Frankfurt plane (FhP). Frankfurt plane is formed by orbitale (Or) and ponion (Po); Mandible: <span class="elsevierStyleBold">7. SNB</span> Angle formed by skull base line (SN) and line N-supramentale (B); <span class="elsevierStyleBold">8. MP-FhP</span> Angle formed by mandibular plane (MP) and Frankfurt plane (FhP); <span class="elsevierStyleBold">9. Go-FC</span> Distance from gonion (Go) to the facial center (FC); <span class="elsevierStyleBold">10. Xi-Pm</span> Distance from Xi to suprapogonion (Pm); Maxilla-Mandible: <span class="elsevierStyleBold">11. ANB</span> Angle formed by subspinale (A) and nasion (N) line and line N-supramentale (B); Hyoid bone: <span class="elsevierStyleBold">12. H-MP</span> Distance from the most anterior and superior point of hyoid bone (H) perpendicular to mandibular plane (MP); Craniocervical Posture: <span class="elsevierStyleBold">13. OPT-SN</span> Angle formed by (SN) and odontoides (OPT). OPT is formed by a line through the postero-superior point and postero-inferior point of odontoides; <span class="elsevierStyleBold">14. CVT-SN</span> Angle formed by (SN) and cervical (CVT). CVT is formed by a line through the postero-superior point and postero-inferior point of the four cervical.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Annel Chambi-Rocha, Ma Eugenia Cabrera-Domínguez, Antonia Domínguez-Reyes" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Annel" "apellidos" => "Chambi-Rocha" ] 1 => array:2 [ "nombre" => "Ma Eugenia" "apellidos" => "Cabrera-Domínguez" ] 2 => array:2 [ "nombre" => "Antonia" "apellidos" => "Domínguez-Reyes" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2255553617301118" "doi" => "10.1016/j.jpedp.2017.08.022" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553617301118?idApp=UINPBA000049" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755717300116?idApp=UINPBA000049" "url" => "/00217557/0000009400000002/v2_202011190930/S0021755717300116/v2_202011190930/en/main.assets" ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Establishment of nasal breathing should be the ultimate goal to secure adequate craniofacial and airway development in children" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "101" "paginaFinal" => "103" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Carlos Torre, Christian Guilleminault" "autores" => array:2 [ 0 => array:3 [ "nombre" => "Carlos" "apellidos" => "Torre" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Christian" "apellidos" => "Guilleminault" "email" => array:1 [ 0 => "cguil@stanford.edu" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "University of Miami, Division of Sleep and Otorhinolaryngology, Coral Gables, Miami, FL, United States" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Stanford University, Sleep Medicine Division, Redwood City, Stanford, CA, United States" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "O estabelecimento da respiração nasal deve ser o objetivo final para garantir desenvolvimento craniofacial e respiratório adequados em crianças" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">As shown for many years and studied again by Chambi-Rocha et al.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> in this issue of the Journal, chronic mouth breathing during active craniofacial development of a child may result in anatomical changes that directly affect the airway.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> These changes may result in greater airway instability and collapsibility that potentially lead to other problems later in life, such as sleep-disordered breathing.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a> Prior investigations of children with mouth breathing have shown a correlation with abnormal orofacial growth.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a> There is also a continuous interaction between nasal breathing and appropriate sucking, swallowing, and mastication to optimize orofacial growth.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">5</span></a> This is especially important in children, in whom the naso-maxillary complex continuously grows from infancy, throughout the pre-pubertal period, and until the completion of puberty. In fact, maximal orofacial growth takes place during the first two years of life; by age 6 years, nearly 60% of the adult face has developed. Therefore, establishing adequate nasal breathing early in life is essential to maximize the growth of the skeletal complex and the upper airway.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">6,7</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The continuous interaction between the nasomaxillary complex and the mandible during nasal breathing is also important to guide the growth of the entire facial-skeletal complex in a forward and horizontal orientation. This interaction lessens the angulation of the occlusal plane, which shortens the airway length, creates intraoral space to accommodate the tongue, leads to a shorter soft palate, and potentially improves the function of airway dilator muscles to help maintain the airway open.<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">8,9</span></a> Therefore, it is reasonable to assume that, in order to maximize the potential of adequate craniofacial and airway development, the ultimate goal should be the establishment of continuous nasal breathing. This, in conjunction with other oral functions such as sucking, swallowing, and mastication, are critical functions that will continuously stimulate the inter-maxillary cartilage from birth until 13–15 years of age. While active, this synchondrosis will allow facial growth through an osteo-chondral ossification mechanism.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Fitzpatrick et al. described how continuous mouth breathing leads to a significant increase in upper-airway-resistance.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a> In the 1980s, a number of groundbreaking experiments shed some light into these human observations, when a group of newborn Rhesus monkeys had their nasal passages blocked during the first six months of life.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a> At the end of this period, the monkeys were found to have narrowing of dental arches, decreased maxillary arch length, anterior cross-bite, maxillary overjet, and increased anterior facial height. EMG recordings of different orofacial and neck muscles also revealed an abrupt induction of rhythmic discharge patterns, very different from the nearly continuous low amplitude and desynchronized discharges most normal subjects have at rest.<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">11,12</span></a> Interestingly, at the end of the six-month period, the Rhesus monkeys were allowed to breathe normally through their noses, which led to normalization of muscle discharge and restoration of adequate orofacial growth.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In humans, restoration of normal nasal breathing continues to be a challenge even after correction of anatomical problems contributing to nasal resistance. Several theories attempt to explain why it is so challenging to re-train a person to become a nasal breather after years of mouth breathing. When there is a “nasal disuse”, there is a loss of proprioception and a functional “de-afferentation” that prevent return to normal nasal air-exchange, even after the anatomical factors contributing to nasal obstruction are corrected.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">13</span></a> Chronic mouth breathing also results in “under-ventilation” of the nose, which may lead to accumulation of inflammatory cells in the nasal mucosa that cause nasal resistance.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a> Finally, the same anatomic disturbances in orofacial growth that result from chronic oral breathing, in particular the narrowing of the dental arches, may limit the intranasal space and may also cause deviation of the nasal septum secondary to its compression by the high arched palate in a cephalo-caudal orientation.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Comparing humans to the Rhesus monkeys may help us understand why there is so little room for error in our species and why it is important to address abnormal nasal breathing and poor oral functions early in life to maximize the growth potential of the craniofacial skeleton. The development of speech in <span class="elsevierStyleItalic">Homo sapiens</span>, as well as the switch to bipedalism, led to the elongation of the airway with the development of a poorly supported 2–4<span class="elsevierStyleHsp" style=""></span>mm oropharynx that lacks an epiglottis lock against the palate.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">16</span></a> In addition, to facilitate speech, there was an anterior migration of the foramen magnum and a regression of the maxillo-mandibular complex in order to establish the 1:1 ratio of the supra vocal cord tract necessary for adequate speech production.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">17</span></a> The regression of the skeletal complex came at the expense of teeth. Compared to humans, which have 32 teeth, other monkey species such as the chimpanzee can have up to 44 teeth. The result of this compromised skeletal complex was a pushback of the tongue, which led it to become an obstructive element by becoming part of the upper airway.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">18</span></a> In monkeys and most other species, the tongue is confined to the oral cavity and does not block the airway.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Nasal breathing during sleep is essential to stimulate adequate ventilation, activate reflexes that help maintain the tonicity of the muscles that stabilize the upper airway, and to avoid the airway instability that results from mouth breathing.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">19</span></a> Addressing mouth breathing during sleep is essential, considering that, at birth, the child spends nearly 80% of the time asleep, and even at 6 years of age they continue to have a prolonged sleeping time where they can spend up to 25% of their day sleeping. Studies monitoring nasal and mouth breathing during sleep have shown that normal individuals spend 96% of their sleep time breathing through their nose.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a> This observation was confirmed by other studies showing that normal children between the ages of 4 and 6 years of age oscillate between 0 to 10% of the time breathing through their mouth during sleep, with a mean of 4% of the time.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Considering all this, it is therefore essential to address any problems such as chronic mouth breathing that contributes to poor skeletal and airway development in children. Under these circumstances, patients may not have enough room to accommodate the tongue or other structures, such as the palatine and lingual tonsils, that may become obstructive elements during sleep. Limited airway space from poor skeletal development may also prevent patients from maintaining adequate airway patency as they progress through the natural stages of sleep and their muscles relax. The combination of these elements may ultimately result in airflow limitation during sleep that leads to frequent arousals and drops in the blood-oxygen saturation levels, which defines what is known as obstructive sleep apnea.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Torre C, Guilleminault C. Establishment of nasal breathing should be the ultimate goal to secure adequate craniofacial and airway development in children. J Pediatr (Rio J). 2018;94:101–3.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">See paper by Chambi-Rocha et al. in pages 123–130.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0105" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breathing mode influence on craniofacial development and head posture" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Chambi-Rocha" 1 => "M.E. Cabrera-Domínguez" 2 => "A. Domínguez-Reyes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Pediatr (Rio J)" "fecha" => "2018" "volumen" => "94" "paginaInicial" => "23" "paginaFinal" => "30" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0110" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of respiratory pattern on craniofacial growth" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Mcnamara" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Angle Orthod" "fecha" => "1981" "volumen" => "51" "paginaInicial" => "269" "paginaFinal" => "300" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0115" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of oral or nasal breathing route on upper airway resistance during sleep" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Fitzpatrick" 1 => "H. McLean" 2 => "A. Urton" 3 => "A. Tan" 4 => "E. O’Donell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.03.00047903" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2003" "volumen" => "22" "paginaInicial" => "827" "paginaFinal" => "832" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14621092" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0120" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dimensions of face and palate in nose breathers and habitual mouth breathers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Linder-Aronson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Odontol Rev" "fecha" => "1969" "volumen" => "14" "paginaInicial" => "187" "paginaFinal" => "200" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0125" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Experiments on the interaction between orofacial function and morphology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K. Vargervik" 1 => "E. Harvold" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ear Nose Throat J" "fecha" => "1987" "volumen" => "66" "paginaInicial" => "201" "paginaFinal" => "208" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3107964" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0130" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Morphometric facial changes and obstructive sleep apnea in adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Guilleminault" 1 => "M. Partinen" 2 => "J.P. Praud" 3 => "M.A. Quera-Salva" 4 => "N. Powell" 5 => "R. Riley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0022-3476(89)80447-0" "Revista" => array:6 [ "tituloSerie" => "J Pediatr" "fecha" => "1989" "volumen" => "114" "paginaInicial" => "997" "paginaFinal" => "999" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2723918" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0135" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mouth breathing children and cephalometric pattern: does the stage of dental development matter?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "B.Q. Souki" 1 => "P.B. Lopes" 2 => "T.B. Pereira" 3 => "L.P. Franco" 4 => "H.M. Becker" 5 => "D.D. Oliveira" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijporl.2012.02.054" "Revista" => array:7 [ "tituloSerie" => "Int J Pediatr Otorhinolaryngol" "fecha" => "2012" "volumen" => "76" "paginaInicial" => "837" "paginaFinal" => "841" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22425033" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1878875018308635" "estado" => "S300" "issn" => "18788750" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0140" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lateral pharyngeal wall tension after maxillomandibular advancement for obstructive sleep apnea is a marker for surgical success: observations from drug-induced sleep endoscopy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.Y. Liu" 1 => "L.K. Huon" 2 => "N.B. Powell" 3 => "R. Riley" 4 => "H.G. Cho" 5 => "C. Torre" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.joms.2015.01.028" "Revista" => array:6 [ "tituloSerie" => "J Oral Maxillofac Surg" "fecha" => "2015" "volumen" => "73" "paginaInicial" => "1575" "paginaFinal" => "1582" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25843814" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0145" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Large maxillomandibular advancements for obstructive sleep apnea: an operative technique evolved over 30 years" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Camacho" 1 => "S. Liu" 2 => "V. Certal" 3 => "R. Capasso" 4 => "N.B. Powell" 5 => "R. Riley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcms.2015.05.015" "Revista" => array:6 [ "tituloSerie" => "J Craniomaxillofac Surg" "fecha" => "2015" "volumen" => "43" "paginaInicial" => "1113" "paginaFinal" => "1118" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26116307" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0150" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primate experiments on oral respiration" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Harvold" 1 => "B. Tomer" 2 => "K. Vargervik" 3 => "G. Chierici" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Orthod" "fecha" => "1981" "volumen" => "79" "paginaInicial" => "359" "paginaFinal" => "372" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0155" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Morphologic response to changes in neuromuscular patterns experimentally induced by altered modes of respiration" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K. Vargervik" 1 => "A. Miller" 2 => "G. Chierici" 3 => "E. Harvold" 4 => "B. Tomer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Orthod" "fecha" => "1984" "volumen" => "85" "paginaInicial" => "115" "paginaFinal" => "124" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0160" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Experimentally induced neuromuscular changes during and after nasal airway obstruction" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.J. Miller" 1 => "K. Vargervik" 2 => "G. Chierici" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0002-9416(84)90159-3" "Revista" => array:6 [ "tituloSerie" => "Am J Orthod" "fecha" => "1984" "volumen" => "85" "paginaInicial" => "385" "paginaFinal" => "392" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6586077" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0165" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mouth breathing, “nasal disuse,” and pediatric sleep-disordered breathing" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Lee" 1 => "C. Guilleminault" 2 => "H. Chiu" 3 => "S. Sullivan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11325-015-1154-6" "Revista" => array:6 [ "tituloSerie" => "Sleep Breath" "fecha" => "2015" "volumen" => "19" "paginaInicial" => "1257" "paginaFinal" => "1264" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25877805" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0170" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Regular CPAP utilization reduces nasal inflammation assessed by nasal cytology in obstructive sleep apnea syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Gelardi" 1 => "G. Carbonara" 2 => "E. Maffezzoni" 3 => "M. Marvisi" 4 => "N. Quaranta" 5 => "R. Ferri" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.sleep.2012.04.004" "Revista" => array:6 [ "tituloSerie" => "Sleep Med" "fecha" => "2012" "volumen" => "13" "paginaInicial" => "859" "paginaFinal" => "863" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22763015" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0175" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The relationship between posterior septum deviation and depth of maxillopalatal arch" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Akbay" 1 => "Y. Cokkeser" 2 => "O. Yilmaz" 3 => "C. Cevik" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.anl.2012.07.016" "Revista" => array:6 [ "tituloSerie" => "Auris Nasus Larynx" "fecha" => "2013" "volumen" => "40" "paginaInicial" => "286" "paginaFinal" => "290" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23083624" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0180" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "What is the role of the larynx in adult obstructive sleep apnea?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.C. Dedhia" 1 => "C.A. Rosen" 2 => "R.J. Soose" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/lary.24494" "Revista" => array:6 [ "tituloSerie" => "Laryngoscope" "fecha" => "2014" "volumen" => "124" "paginaInicial" => "1029" "paginaFinal" => "1034" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24353028" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0185" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Voice acoustic patterns of patients diagnosed with vibroacoustic disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Mendes" 1 => "M. Alves-Pereira" 2 => "N.A. Castelo Branco" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Port Pneumol" "fecha" => "2006" "volumen" => "12" "paginaInicial" => "375" "paginaFinal" => "382" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16969570" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0190" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Posture of the head, the hyoid bone, and the tongue in children with and without enlarged tonsils" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K. Behlfelt" 1 => "S. Linder-Aronson" 2 => "P. Neander" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ejo/12.4.458" "Revista" => array:6 [ "tituloSerie" => "Eur J Orthod" "fecha" => "1990" "volumen" => "12" "paginaInicial" => "458" "paginaFinal" => "467" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2086266" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0195" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nasal involvement in obstructive sleep apnea syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Michels" 1 => "S. de" 2 => "A. Rodrigues" 3 => "M.S. da" 4 => "M.M. Nakanishi" 5 => "A.L. Sampaio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2014/717419" "Revista" => array:5 [ "tituloSerie" => "Int J Otolaryngol" "fecha" => "2014" "volumen" => "2014" "paginaInicial" => "717419" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25548569" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0200" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Partitioning of inhaled ventilation between the nasal and oral routes during sleep in normal subjects" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.F. Fitzpatrick" 1 => "H.S. Driver" 2 => "N. Chatha" 3 => "N. Voduc" 4 => "A.M. Girard" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Appl Physiol (1985)" "fecha" => "2003" "volumen" => "94" "paginaInicial" => "883" "paginaFinal" => "890" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00217557/0000009400000002/v2_202011190930/S0021755717308318/v2_202011190930/en/main.assets" "Apartado" => array:4 [ "identificador" => "46150" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorial" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/00217557/0000009400000002/v2_202011190930/S0021755717308318/v2_202011190930/en/main.pdf?idApp=UINPBA000049&text.app=https://jped.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755717308318?idApp=UINPBA000049" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 2 | 7 |
| 2024 October | 38 | 24 | 62 |
| 2024 September | 48 | 33 | 81 |
| 2024 August | 47 | 58 | 105 |
| 2024 July | 56 | 52 | 108 |
| 2024 June | 35 | 21 | 56 |
| 2024 May | 39 | 15 | 54 |
| 2024 April | 56 | 25 | 81 |
| 2024 March | 46 | 18 | 64 |
| 2024 February | 36 | 19 | 55 |
| 2024 January | 37 | 29 | 66 |
| 2023 December | 17 | 22 | 39 |
| 2023 November | 34 | 35 | 69 |
| 2023 October | 28 | 37 | 65 |
| 2023 September | 22 | 37 | 59 |
| 2023 August | 19 | 15 | 34 |
| 2023 July | 19 | 11 | 30 |
| 2023 June | 18 | 9 | 27 |
| 2023 May | 21 | 25 | 46 |
| 2023 April | 19 | 8 | 27 |
| 2023 March | 37 | 13 | 50 |
| 2023 February | 44 | 16 | 60 |
| 2023 January | 21 | 16 | 37 |
| 2022 December | 42 | 23 | 65 |
| 2022 November | 24 | 27 | 51 |
| 2022 October | 43 | 32 | 75 |
| 2022 September | 21 | 33 | 54 |
| 2022 August | 29 | 31 | 60 |
| 2022 July | 35 | 35 | 70 |
| 2022 June | 25 | 27 | 52 |
| 2022 May | 19 | 25 | 44 |
| 2022 April | 30 | 27 | 57 |
| 2022 March | 28 | 48 | 76 |
| 2022 February | 17 | 23 | 40 |
| 2022 January | 16 | 25 | 41 |
| 2021 December | 14 | 21 | 35 |
| 2021 November | 13 | 12 | 25 |
| 2021 October | 13 | 21 | 34 |
| 2021 September | 12 | 19 | 31 |
| 2021 August | 6 | 10 | 16 |
| 2021 July | 9 | 1 | 10 |
| 2021 June | 13 | 13 | 26 |
| 2021 May | 24 | 17 | 41 |
| 2021 April | 21 | 12 | 33 |
| 2021 March | 32 | 12 | 44 |
| 2021 February | 17 | 10 | 27 |
| 2021 January | 13 | 9 | 22 |
| 2020 December | 27 | 9 | 36 |
| 2020 November | 12 | 17 | 29 |
| 2020 October | 11 | 11 | 22 |
| 2020 September | 10 | 12 | 22 |
| 2020 August | 5 | 2 | 7 |
| 2020 July | 11 | 5 | 16 |
| 2020 June | 9 | 2 | 11 |
| 2020 May | 22 | 4 | 26 |
| 2020 April | 17 | 9 | 26 |
| 2020 March | 26 | 2 | 28 |
| 2020 February | 28 | 10 | 38 |
| 2020 January | 26 | 13 | 39 |
| 2019 December | 15 | 7 | 22 |
| 2019 November | 17 | 4 | 21 |
| 2019 October | 17 | 13 | 30 |
| 2019 September | 31 | 10 | 41 |
| 2019 August | 22 | 11 | 33 |
| 2019 July | 43 | 11 | 54 |
| 2019 June | 43 | 10 | 53 |
| 2019 May | 50 | 9 | 59 |
| 2019 April | 63 | 16 | 79 |
| 2019 March | 39 | 16 | 55 |
| 2019 February | 15 | 10 | 25 |
| 2019 January | 26 | 9 | 35 |
| 2018 December | 19 | 8 | 27 |
| 2018 November | 28 | 5 | 33 |
| 2018 October | 37 | 14 | 51 |
| 2018 September | 20 | 8 | 28 |
| 2018 August | 9 | 10 | 19 |
| 2018 July | 15 | 4 | 19 |
| 2018 June | 14 | 6 | 20 |
| 2018 May | 70 | 27 | 97 |
| 2018 April | 36 | 15 | 51 |
| 2018 March | 21 | 17 | 38 |
| 2018 February | 5 | 6 | 11 |
| 2018 January | 2 | 2 | 4 |
| 2017 December | 0 | 0 | 0 |
| 2017 November | 1 | 3 | 4 |
| 2017 October | 1 | 11 | 12 |
Show all
