Yakubova Zulfiya

Title: Assessment of autonomic nervous system maladaptation in children with mandibular deformities

Abstract

Childhood and adolescence are characterized by significant neuroendocrine and autonomic reorganization coinciding with intensive growth, development, and increased educational stress. During puberty, activation of the sympathoadrenal system ensures adaptive responses to external factors. However, in the presence of chronic somatic and maxillofacial pathology, including mandibular deformities, these mechanisms may become impaired, leading to autonomic maladaptation

Study objective: To assess the functional state and autonomic support of the autonomic nervous system in children with mandibular deformities.

Materials and Methods. A total of 26 children aged 12–16 years were examined, including 12 boys (46.1%) and 14 girls (53.8%). Clinical neurological examination and assessment of autonomic nervous system function using the Wayne questionnaire were performed. The severity of autonomic dysfunction was determined based on the total score. The study was conducted at the outpatient clinic of TashPMI in collaboration with the Republican Diagnostic Center (Tashkent).

Outcomes. Most adolescents demonstrated chronic somatic pathology and functional disturbances. In boys, musculoskeletal and connective tissue disorders predominated (51%), followed by nervous system diseases (29%) and upper respiratory tract disorders (20%). In girls, nervous system diseases were most prevalent (57.3%), followed by musculoskeletal disorders (26%) and upper respiratory tract pathology (16.7%).

Neurological examination revealed hyperreflexia (46.5%), positive Chvostek’s sign (21.7%), palmar and plantar hyperhidrosis (19.2%), and skin mottling (12.6%). The mean Wayne questionnaire score was 21.6 points, indicating the presence of autonomic dysfunction. Autonomic-corrective therapy and planned management of somatic comorbidities were prescribed according to the severity of autonomic disturbances.

Conclusions: Children with mandibular deformities demonstrate signs of autonomic nervous system maladaptation, highlighting the need for early screening, preventive neurological assessment, and timely correction of autonomic imbalance. Maintenance of autonomic homeostasis through supportive autonomic-corrective therapy may enhance adaptive and compensatory mechanisms.