Oropharyngeal and tongue exercises (myofunctional therapy) for snoring: a systematic review and meta-analysis

Camacho, Macario; Guilleminault, Christian; Wei, Justin M.; Song, Sungjin A.; Noller, Michael; Reckley, Lauren K.; Fernandez-Salvador, Camilo; Zaghi, Soroush

doi:10.1007/s00405-017-4848-5

Cited by 52 publications

(29 citation statements)

References 21 publications

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“…Renewed interest for myofunctional therapy was garnered with a series of randomized control trials and cohort studies investigating the role of oropharyngeal exercises, speech therapy, myofascial reeducation, and oronasal rehabilitation for adults and children with sleep‐disordered breathing. Furthermore, a more recent series of meta‐analysis, review articles, books, commentaries, and position statements have catapulted myofunctional therapy to the forefront of the attention within dental and medical communities, albeit not without criticism.…”

Section: Discussionmentioning

confidence: 99%

“…Orofacial myofunctional therapy (also known as orofacial myology) has been used for many years to repattern maladaptive oral habits (such as prolonged thumb‐sucking, nail biting, tongue thrusting, and open‐mouth at rest posture) among other objectives . More recently, myofunctional therapy has been demonstrated as a potentially effective treatment option for sleep‐disordered breathing . However, restricted tongue mobility may interfere with the goals and limit the efficacy of myofunctional therapy.…”

Section: Methodsmentioning

confidence: 99%

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Lingual frenuloplasty with myofunctional therapy: Exploring safety and efficacy in 348 cases

Zaghi

Valcu‐Pinkerton²,

Jabara³

et al. 2019

Laryngoscope Investig Oto

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Background Ankyloglossia is a condition of altered tongue mobility due to the presence of restrictive tissue between the undersurface of the tongue and the floor of mouth. Potential implications of restricted tongue mobility (such as mouth breathing, snoring, dental clenching, and myofascial tension) remain underappreciated due to limited peer‐reviewed evidence. Here, we explore the safety and efficacy of lingual frenuloplasty and myofunctional therapy for the treatment of these conditions in a large and diverse cohort of patients with restricted tongue mobility. Methods Four hundred twenty consecutive patients (ages 29 months to 79 years) treated with myofunctional therapy and lingual frenuloplasty for indications of mouth breathing, snoring, dental clenching, and/or myofascial tension were surveyed. All procedures were performed by a single surgeon using a scissors and suture technique. Safety and efficacy was assessed >2 months postoperatively by means of patient‐reported outcome measures. Results In all, 348 surveys (83% response rate) were completed showing 91% satisfaction rate and 87% rate of improvement in quality of life through amelioration of mouth breathing (78.4%), snoring (72.9%), clenching (91.0%), and/or myofascial tension (77.5%). Minor complications occurred in <5% of cases including complaints of prolonged pain or bleeding, temporary numbness of the tongue‐tip, salivary gland issues, minor wound infection or inflammation, and need for revision to excise scar tissue. There were no major complications. Conclusion Lingual frenuloplasty with myofunctional therapy is safe and potentially effective for the treatment of mouth breathing, snoring, clenching, and myofascial tension in appropriately selected patient candidates. Further studies with objective measures are merited. Level of Evidence 3

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Lingual frenuloplasty with myofunctional therapy: Exploring safety and efficacy in 348 cases

Zaghi

Valcu‐Pinkerton²,

Jabara³

et al. 2019

Laryngoscope Investig Oto

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“…Estos resultados han sido confirmados en diversas series de pacientes con SAHOS, resumidos en un reciente metaanálisis [13][14][15] . Otras ventajas descritas en la respuesta a la TMO son la reducción en 30% a 51% la intensidad y frecuencia de los ronquidos 16,17 , y una mejor adherencia al uso de CPAP cuando se la indica como terapia coadyuvante 18 . Diaféria y cols demostraron que los pacientes con SAHOS tratados con TMO más CPAP tenían una mayor mejoría en los parámetros de calidad de vida respecto a aquellos pacientes tratados sólo con CPAP 19 .…”

Section: Discussionunclassified

Tratamiento del síndrome de apneas e hipopneas obstructivas del sueño con terapia miofuncional orofaríngea: Experiencia en hospital público de Chile

S¹,

C²,

G³

et al. 2019

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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“…protruding the tongue, 8 lifting the tongue, 9 moving the tongue in different directions, 10 pressing the tongue against bony and soft tissue structures within the oral cavity, 10 sucking the tongue against the palate, 10 moving the tongue to the right and left over the upper incisor teeth, 11 and other tongue movements with or without external against resistance. 10 Some authors have shown the effectiveness of myofunctional therapy in reducing snoring and sleep apnoea/hypopnoea in children. 10,12,13 One study 14 Tongue training not only induces changes at muscle levels, but also elicits neuroplastic changes in the motor cortex.…”

mentioning

confidence: 99%

“…10 Some authors have shown the effectiveness of myofunctional therapy in reducing snoring and sleep apnoea/hypopnoea in children. 10,12,13 One study 14 Tongue training not only induces changes at muscle levels, but also elicits neuroplastic changes in the motor cortex. 9,[16][17][18] Studies showed that tongue-protrusion training, 16 as well as tongue-lift training, 9 induced significant changes in the motor threshold of the tongue musculature and in the amplitude of the motor-evoked potentials elicited by transcranial magnetic stimulation.…”

mentioning

confidence: 99%

The influence of tongue mobility on children's performance in computer games that depend on lingual movements

Amaral

Furlan

Casas

et al. 2020

J of Oral Rehabilitation

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Background Alteration in tongue mobility requires rehabilitation work through oral motor exercises. These exercises can be integrated with computer games to increase the patient’s motivation during treatment. Objective To investigate the influence of tongue mobility on children’s motor performance in a computer game reliant on lingual movements. Methods A cross‐sectional descriptive observational study was carried out with 16 children with altered tongue mobility and 16 children with normal tongue mobility. The subjects were between 8 and 12 years of age. They underwent a clinical evaluation of the tongue and performed an activity using an intra‐oral joystick controlled by the tongue to play a simple computer game. The game consisted of targets appearing on the screen that the participants had to reach by moving the joystick control rod. Afterward, the participants answered a feedback questionnaire. Motor performance in the game, measured by the number of reached targets and by the time to reach the targets, was compared between groups and across directions of tongue movement and order of appearance of the targets. Results The group with altered tongue mobility presented a higher time to reach the target in the downward direction and in the first and last 12 targets and a lower number of targets reached in the left direction, upward direction, and in the first 12 targets than the control group. The direction of the movement influenced tongue performance in both groups. Conclusion Children with altered tongue mobility exhibited a worse performance than those with normal tongue mobility.

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Oropharyngeal and tongue exercises (myofunctional therapy) for snoring: a systematic review and meta-analysis

Abstract: This systematic review demonstrated that myofunctional therapy has reduced snoring in adults based on both subjective questionnaires and objective sleep studies.

Cited by 52 publications

References 21 publications

Lingual frenuloplasty with myofunctional therapy: Exploring safety and efficacy in 348 cases

Lingual frenuloplasty with myofunctional therapy: Exploring safety and efficacy in 348 cases

Tratamiento del síndrome de apneas e hipopneas obstructivas del sueño con terapia miofuncional orofaríngea: Experiencia en hospital público de Chile

The influence of tongue mobility on children's performance in computer games that depend on lingual movements

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