Impacto da rinite alérgica e da hipertrofia adenotonsilar no comportamento e em aspectos cognitivos da criança avaliado por métodos objetivos específicos

Abstract

Introduction: Allergic rhinitis (AR) and adenotonsillar hypertrophy (ATH) are very prevalent conditions in pediatric population and a significant portion of affected children exhibit signs of behavioral and cognitive impairment. The magnitude and reversibility of this dysfunction is still unclear. It is essential to carry out studies that evaluate this impact objectively. Objective: Compare the performance on the Swanson, Nolan and Pelham Scale version IV (SNAP-IV) and Strengths and Difficulties Questionnaire (SDQ) and on the Cognitive Auditory Evoked Potential (P300) among patients with ATH and/or AR compared to children without upper airway obstruction of the same age group. Methods: 44 children aged 6-14 years were equally distributed into 4 groups: control and mouth breathers (AR, ATH and ATH+AR), according to findings in clinical evaluation and complementary exams. All children underwent immediate hypersensitivity skin test, nasopharyngolaryngoscopy, pure-tone, speech and impedance audiometry, active anterior rhinomanometry, SDQ, SNAP-IV and P300. The presence of cognitive and/or behavioral dysfunction was determined by the presence of abnormal results in SDQ, SNAP-IV or P300. Results: Children with ATH and/or AR presented higher scores on the emotional problems (p = 0.001), conduct (p = 0.029) and hyperactivity (p = 0.001) scales and worse scores on the prosocial scale (p = 0.015) of the SDQ. They also showed more symptoms of inattention (p = 0.003) and impulsivity (p = 0.000) on the SNAP-IV. Latency of the P300 was higher in mouth breathing children (p = 0.017). Conclusion: Children with ATH and/or AR showed increased nasal resistance, greater emotional and conduct dysregulation, more hyperactivity, inattention and impulsivity problems, lower social skills, and lower performance in a test that evaluated attention and working memory than healthy children of the same age group. No statistically significant difference was found by mouth breathing etiology.