Passive myofunctional therapy applied on children with obstructive sleep apnea: A 6-month follow-up

Chuang, Li-Chuan; Lian, Yun‐Chia; Hervy-Auboiron, Michèle; Guilleminault, Christian; Huang, Yu‐Shu

doi:10.1016/j.jfma.2016.08.002

Cited by 35 publications

(22 citation statements)

References 11 publications

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“…Additionally, both intrinsic and extrinsic factors have been reported to affect the risk of collapsibility of the upper airways. For instance, fat deposits can induce narrowing of the upper airway and muscle infiltration can reduce the activity and effectiveness of pharynx dilatation muscles; weight loss in children affected by OSA has been recommended in selected cases 267 .…”

Section: Discussionmentioning

confidence: 99%

Assessment of obstructive sleep apnoea (OSA) in children: an update

Savini

Ciorba

Bianchini

et al. 2019

Acta Otorhinolaryngol Ital

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SUMMARYOSA is a condition characterised by episodes of complete or partial obstruction of the upper airway, associated with blood-gas changes and atypical sleep patterns. Early diagnosis of OSA may reduce the occurrence of systemic complications over time, although the diagnosis of OSA is, unfortunately, often late. The aim of the work is to review the current concepts in evaluation of paediatric obstructive sleep apnoea (OSA), with an updated revision of the literature considering risk factors, clinical manifestations, and basic and advanced assessment in the paediatric population. For this narrative review, PubMed, Embase and Cinahl databases were searched for the last 10 years, according to PRISMA criteria/guidelines. Assessment of paediatric OSA remains challenging and paediatric patients should always be carefully evaluated; polysomnography is the gold standard for diagnosis of paediatric OSA.

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Section: Discussionmentioning

confidence: 99%

Assessment of obstructive sleep apnoea (OSA) in children: an update

Savini

Ciorba

Bianchini

et al. 2019

Acta Otorhinolaryngol Ital

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“…The frequency of pediatric OSA can be significantly decreased if "fundamental functions" (nasal breathing, sucking, swallowing, masticating, and phonation) are regularly evaluated for appropriate development, and if any ex-isting defect is properly addressed. Treatments allowing normal development exist, and educational material and training for parents is available; the education of specialists and diffusion of existing knowledge, including to parents, is needed [35] .…”

Section: Resultsmentioning

confidence: 99%

Pediatric Obstructive Sleep Apnea: Where Do We Stand?

Huang

Guilleminault

2017

Advances in Oto-Rhino-Laryngology

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Pediatric obstructive sleep apnea (OSA) was initially described in 1976. In 1981, Dr. Guilleminault emphasized that pediatric OSA was different from the clinical presentation reported in adults. It was characterized by more disturbed nocturnal sleep than excessive daytime sleepiness, and presented more behavioral problems, particularly school problems, hyperactivity, nocturnal enuresis, sleep terrors, depression, insomnia, and psychiatric problems. The underlying causes of pediatric OSA are complex. Such factors as adenotonsillar hypertrophy, obesity, anatomical and neuromuscular factors, and hypotonic neuromuscular disease are also involved. Adenotonsillectomy (T&A) has been the recommended treatment for pediatric OSA, but in the recent past this practice has been placed very much in question. Therefore, we will discuss the mechanism of pediatric OSA and investigate obese and nonobese pediatric sleep-disordered breathing. Moreover, the important concept that dysfunction leads to the dysmorphism that impacts on the size of the Lin H-C (ed): Sleep-Related Breathing Disorders.

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“…30 The role of myofunctional therapy in the management of OSA in adults and in children with OSA has been increasingly studied. 31 32 33 34 Active and passive myofunctional therapy involves isotonic and isometric exercises in order to strengthen the oral cavity and the oropharyngeal structures. A meta-analysis of myofunctional therapy outcomes in children revealed complete remission of OSA in ∼ 60% of the children who complied with the treatment.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Tongue Base Reduction and Lingual Tonsillectomy for Residual Pediatric Obstructive Sleep Apnea after Adenotonsillectomy

Ulualp

2019

Int Arch Otorhinolaryngol

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Introduction Upper airway obstruction at multiple sites, including the velum, the oropharynx, the tongue base, the lingual tonsils, or the supraglottis, has been resulting in residual obstructive sleep apnea (OSA) after tonsillectomy and adenoidectomy (TA). The role of combined lingual tonsillectomy and tongue base volume reduction for treatment of OSA has not been studied in nonsyndromic children with residual OSA after TA. Objective To evaluate the outcomes of tongue base volume reduction and lingual tonsillectomy in children with residual OSA after TA. Methods A retrospective chart review was conducted to obtain information on history and physical examination, past medical history, findings of drug-induced sleep endoscopy (DISE), of polysomnography (PSG), and surgical management. Pre- and postoperative PSGs were evaluated to assess the resolution of OSA and to determine the improvement in the obstructive apnea-hypopnea index (oAHI) before and after the surgery. Results A total of 10 children (5 male, 5 female, age range: 10–17 years old, mean age: 14.5 ± 2.6 years old) underwent tongue base reduction and lingual tonsillectomy. Drug-induced sleep endoscopy (DISE) revealed airway obstruction due to posterior displacement of the tongue and to the hypertrophy of the lingual tonsils. All of the patients reported subjective improvement in the OSA symptoms. All of the patients had improvement in the oAHI. The postoperative oAHI was lower than the preoperative oAHI ( p < 0.002). The postoperative apnea-hypopnea index during rapid eye movement sleep (REM-AHI) was lower than the preoperative REM-AHI ( p = 0.004). Obstructive sleep apnea was resolved in children with normal weight. Overweight and obese children had residual OSA. Nonsyndromic children had resolution of OSA or mild OSA after the surgery. Conclusions Tongue base reduction and lingual tonsillectomy resulted in subjective and objective improvement of OSA in children with airway obstruction due to posterior displacement of the tongue and to hypertrophy of the lingual tonsils.

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Passive myofunctional therapy applied on children with obstructive sleep apnea: A 6-month follow-up

Abstract: Using a specialized oral device to perform myofunctional therapy during sleep may improve the breathing during sleep of children with obstructive sleep apnea.

Cited by 35 publications

References 11 publications

Assessment of obstructive sleep apnoea (OSA) in children: an update

Assessment of obstructive sleep apnoea (OSA) in children: an update

Pediatric Obstructive Sleep Apnea: Where Do We Stand?

Outcomes of Tongue Base Reduction and Lingual Tonsillectomy for Residual Pediatric Obstructive Sleep Apnea after Adenotonsillectomy

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