Nasal patency and craniocervical posture in scholar children

ABSTRACT Changes in head posture have been observed as a compensatory mechanism for the nasal airflow impairment. This study aimed to compare the craniocervical posture between children with normal and decreased nasal patency and correlate nasal patency with craniocervical posture. Children aging from six to twelve years went through nasal patency and craniocervical assessments. The biophotogrammetric measures of craniocervical posture used were Cervical Distance (CD), Head Horizontal Alignment (HHA) and Flexion-Extension Head Position (FE), evaluated by SAPO software (v.0.68). Nasal patency was measured using Peak Nasal Inspiratory Flow meter (PNIF) and Nasal Obstruction Symptom Evaluation (NOSE) scale. One hundred thirty-three children were distributed into two groups: G1 (normal nasal patency - PNIF higher than 80% of predicted value) with 90 children; G2 (decreased nasal patency - PNIF lower than 80% of predicted value) with 43 children. Differences between groups were not found in CD and HHA measures. FE was significantly higher in G2 than G1 (p=0.023). Negative weak correlation between FE and %PNIF (r=-0.266; p=0.002) and positive weak correlation between CD and PNIF (r=0.209; p=0.016) were found. NOSE scores negatively correlated with PNIF (r=-0.179; p=0.039). Children with decreased nasal patency presented greater head extension. This postural deviation is prone to increase as nasal airflow decreases, thus indicating the relationship between craniocervical posture and nasal patency. Lower values of PNIF reflected on additional problems caused by nasal obstruction symptoms.

摘要：头部姿势的改变已被证实为鼻腔气流受损时的代偿机制。本研究旨在对比鼻腔通畅度正常与降低的儿童的颅颈姿势，并分析鼻腔通畅度与颅颈姿势的相关性。研究纳入6至12岁儿童，对其开展鼻腔通畅度及颅颈姿势评估。颅颈姿势的生物摄影测量指标包括颈距（Cervical Distance, CD）、头部水平对齐度（Head Horizontal Alignment, HHA）以及头屈伸位置（Flexion-Extension Head Position, FE），均通过SAPO软件（v.0.68）进行评测。鼻腔通畅度采用峰值鼻吸气流量仪（Peak Nasal Inspiratory Flow meter, PNIF）与鼻腔阻塞症状评估量表（Nasal Obstruction Symptom Evaluation, NOSE）进行测量。本研究共纳入133名儿童，分为两组：G1组（鼻腔通畅度正常——PNIF值高于预测值的80%）共90例；G2组（鼻腔通畅度降低——PNIF值低于预测值的80%）共43例。两组在CD与HHA指标上未发现显著差异；但G2组的FE值显著高于G1组（p=0.023）。研究发现FE与PNIF百分比呈弱负相关（r=-0.266；p=0.002），CD与PNIF值呈弱正相关（r=0.209；p=0.016）。NOSE评分与PNIF值呈负相关（r=-0.179；p=0.039）。鼻腔通畅度降低的儿童表现出更明显的头部后仰姿势。该姿势偏差会随鼻腔气流受损程度加重而加剧，由此证实颅颈姿势与鼻腔通畅度之间存在关联。更低的PNIF值则提示鼻腔阻塞症状带来的额外健康问题。