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Obstructive Sleep Apnoea Syndrome (OSAS) is believed to be associated with craniofacial and neuromuscular changes, although the interplay among these variables still is poorly recognised. The objective of this study was to identify hyoid, muscular and swallowing changes associated with OSAS, and to correlate these alterations with OSAS severity. Cross-sectional study, in a tertiary referral centre. Seventy-two adult individuals participated in this study: 12 controls (without apnoea) and 60 patients with apnoea (mild, moderate and severe OSAS-20 individuals in each group). All participants were initially evaluated by otorhinolaryngologist and neurologist and underwent polysomnography for OSAS stratification. Cephalometric data, clinical myofunctional status and swallow videofluoroscopy exam were assessed. A hybrid effect model was used to analyse swallowing parameters; dependent variables were age, body mass index (BMI) and cephalometric measures. Individuals with OSAS presented lower hyoid position and narrower posterior airway distance when compared to controls. These parameters correlated to OSAS severity. Additionally, OSAS patients exhibited significantly lower myofunctional scores. Both velum and hyoid contraction times were significantly lower in the OSAS group at videofluoroscopy, regardless of its severity. Premature leakage into pharynx was more common in OSAS groups. Laryngeal penetration phenomenon occurred only in two patients (both from OSAS group). Our results suggest that hyoid bone position is associated with OSAS severity. Muscular pattern and swallowing are impaired in OSAS patients, irrespective of OSAS severity and facial profile. These findings indicate a higher predisposition of OSAS patients to present an inferior hyoid positioning, accompanied by myofunctional and swallowing disorders.

Aim: Breast-feeding promotes several benefits in childhood, among them favoring the nasal breathing. In the present study, the relationship between breathing pattern and the history of breast-feeding and of deleterious oral habits was determined. Study design: clinical with transversal cohort. Material and Method: The study population consisted of 62 children ranging in age from 3 years and 3 months to 6 years and 11 months who were submitted to otorhinolaryngologic evaluation to determine nasal and mouth breathers and to a speech language pathologic interview. The otorhinolaryngologic evaluation involved the following exams: anterior rhinoscopy, oroscopy and radiologic examination. The parents of the children were questioned about the form of feeding (natural and/or artificial), the duration of breast-feeding and the presence of deleterious oral habits (suction and biting). The Fisher exact test was used to compare groups regarding the presence and absence of habits and the different periods of breast-feeding. Results: The breast-feeding period was longer among nasal breathers and was concentrated in the period between 3 and 6 months of age. Regarding the use of bottle, the results showed that most of the children in both groups used this type of feeding during the first years of life, with no significant difference between groups (p=0.58). There was a marked presence of deleterious oral habits among mouth breathers, with a statistically significant difference between groups regarding suction (p=0.004) and biting habits (p=0.0002). Conclusion: Mouth breathing children were breast-fed for a shorter period of time and had a history of deleterious oral habits compared to nose breathers.

Parents cannot clearly correlate tonsillar hypertrophy with changes in mastication and deglutition. The cause of the respiratory obstruction does not seem to interfere in the pattern of myofunctional change.