Orofacial motor functions in pediatric obstructive sleep apnea and implications for myofunctional therapy

Felício, Cláudia Maria de; Dias, Franciele Voltarelli da Silva; Folha, Gislaine Aparecida; Almeida, Lucas Ferreira de; Souza, Jaqueline Freitas de; Anselmo‐Lima, Wilma Terezinha; Trawitzki, Luciana Vitaliano Voi; Valera, Fabiana Cardoso Pereira

doi:10.1016/j.ijporl.2016.08.019

Cited by 55 publications

(45 citation statements)

References 33 publications

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“…In the clinical evaluation of swallowing, we observed important alterations in the four categories assessed: lips, tongue, other behaviors, and the efficiency of swallowing. These findings are in accordance with previous studies in the literature that evaluated children with tonsillar hypertrophy and OSA and reported lower swallowing scores …”

Section: Discussionsupporting

confidence: 93%

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Swallowing patterns after adenotonsillectomy in children

Branco

Corrêa

Neves

et al. 2019

Pediatric Investigation

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Importance Hypertrophy of the pharyngeal and palatine tonsils can interfere with breathing, physical and cognitive development, and quality of life, including sleep quality. There are important relationships between the muscles of the airways, the anatomy, and the pattern of breathing and swallowing. Objective The aims of the present study were to evaluate the swallowing process in children after adenotonsillectomy undertaken to treat obstructive breathing disorders. Methods Subjects were 85 children or adolescents who underwent adenotonsillectomy in a reference hospital between 2003 and 2007. For the clinical evaluation of swallowing, the protocol of orofacial myofunctional evaluation with scores (OMES) was used, videofluoroscopy of deglutition was performed, and the Dysphagia Outcome and Severity Scale (DOSS) and Classification for Severity of Dysphagia to Videofluoroscopy Scale were applied for analysis. Results Out of the 85 evaluated children, 43 were male (50.59%), the average age at evaluation was 12.11 years, the average age at the time of surgery was 6.73 years, and post‐surgery time was 3.00–8.00 years. In the clinical evaluation of swallowing, half the sample (50.59%) recorded the poorest score for lip and tongue behavior. A score of 1 was observed in 67.06% of subjects for other behaviors, and in 15.30% of subjects for efficiency of swallowing. Videofluoroscopic analysis demonstrated that the most frequent swallowing alterations were labial sealing (50.59%), residue in vallecula (51.76%), and use of compensatory maneuvers (61.18%). Analysis of DOSS showed that normal swallowing was attributed to 48.31% of subjects at level 7, 44.95% at level 6, and 6.74% at level 5. For the Classification for Severity of Dysphagia to Videofluoroscopy, 75.28% were classified as having mild dysphagia. Interpretation Alterations in the dynamics of swallowing are common in children who have undergone surgery of the tonsils, even at late follow‐up.

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Section: Discussionsupporting

confidence: 93%

“…Sleep‐disorder breathing is correlated not only with hypertrophy of the tonsils, but also with reduced muscular coordination and alteration of orofacial functions involving the stomatognathic system, consisting of suction, mastication, swallowing, nasal breathing and speech (phonetics) …”

Section: Introductionmentioning

confidence: 99%

Swallowing patterns after adenotonsillectomy in children

Branco

Corrêa

Neves

et al. 2019

Pediatric Investigation

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“…Felício and co‐workers measured anterior tongue elevation pressure using the IOPI in 39 Portuguese‐speaking children aged 7‐10 years. Of those, 27 were diagnosed with obstructive sleep apnea and 12 with primary snoring.…”

Section: Discussionmentioning

confidence: 99%

“…22 Other researchers have found that the forward head posture requires greater effort for suprahyoid muscle recruitment. 23 Felício and co-workers 19 measured anterior tongue elevation pressure using the IOPI in 39 Portuguese-speaking children aged 7-10 years. Of those, 27 were diagnosed with obstructive sleep apnea and 12 with primary snoring.…”

Section: Discussionmentioning

confidence: 99%

Tongue pressure measurement in children with mouth‐breathing behaviour

Azevedo

Lima

Furlan

et al. 2018

J of Oral Rehabilitation

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The tongue plays an important role in oral functions. Reduced tongue strength is often noted among children with mouth-breathing behaviour. The purposes of this study were to measure the tongue pressure in children with mouth-breathing behaviour, to compare these values to those of children with nasal-breathing behaviour and to analyse the relationship between age and tongue pressure in children with a mouth-breathing pattern and in children with a nasal-breathing pattern. In this cross-sectional analytical observational study, we enroled 40 children aged 5-12 years who either exhibited mouth-breathing behaviour (n = 20) or nasal-breathing behaviour (gender- and age-matched [±2 years] controls; n = 20). Tongue pressure was evaluated using the Iowa Oral Performance Instrument; 3 measurements were recorded for each participant, with a 30-seconds rest interval. The average tongue pressure in the mouth-breathing group was lower than that in the nasal-breathing group. There was no difference in tongue pressure between genders. There was a strong and direct correlation between tongue pressure and age in the nasal-breathing group. The breathing pattern impacts tongue pressure development.

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“…It consists of an air bulb connected to a pressure transducer and has been increasingly used in several countries in research and clinical practice 7 Researchers have used IOPI to measure the tongue of adults 8 , children and adolescents 9 , individuals with dysphagia 10 , cleft lip and palate 11 , obstructive sleep apnea 12 , head and neck cancer 13 , muscular dystrophy 14 , Parkinson's disease 15 , individuals who suffered head injury 16 and other changes. Besides, data provided by the IOPI were used to prove the efficacy of Speech-Language Pathologyto increasethe tongue strength 17,18 .…”

Section: Introductionmentioning

confidence: 99%

Correlation between tongue pressure and electrical activity of the suprahyoid muscles

et al. 2017

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Objective: to investigate the correlation between the tongue pressure and the electrical activity of the suprahyoid muscles. Methods: a across-sectional, observational and analytical study conducted with 15 men and 22 women. Each participant underwent simultaneous assessment of maximal tongue pressure through the Iowa Oral Performance Instrument (IOPI) and the surface electromyography of the suprahyoid muscles. They were asked to press the tongue against the hard palate in the anterior and posterior region, with and without IOPI. The adopted significance level of the performed analyses was 5%.Results: there was a moderate and significant correlation only between suprahyoid electrical activity and tongue pressure in the posterior region. It was verified that the measured electrical potentials, when using the IOPI, were greater in the tasks of anterior pressure than in the tasks of the posterior one, bilaterally. Without using the IOPI, the electrical potentials were greater in the posterior pressure than in the anterior one, bilaterally. Finally, the values of lingual pressure were compared with the bulb positioned in the anterior and posterior parts, and the anterior tongue pressure was higher. Conclusion: there was a moderate correlation between tongue pressure and electrical potential of the suprahyoid muscles, researched by the surface electromyography, only when performing activities with the posterior portion of the tongue.

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Orofacial motor functions in pediatric obstructive sleep apnea and implications for myofunctional therapy

Cited by 55 publications

References 33 publications

Swallowing patterns after adenotonsillectomy in children

Swallowing patterns after adenotonsillectomy in children

Tongue pressure measurement in children with mouth‐breathing behaviour

Correlation between tongue pressure and electrical activity of the suprahyoid muscles

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