Speech-language pathology findings in patients with mouth breathing: Multidisciplinary diagnosis according to etiology

Abstract

The purpose of this study was to identify and compare the results of the findings from speech-language pathology evaluations for orofacial function including tongue and lip rest postures, tonus, articulation and speech, voice and language, chewing, and deglutition in children who had a history of mouth breathing. The diagnoses for mouth breathing included: allergic rhinitis, adenoidal hypertrophy, allergic rhinitis with adenoidal hypertrophy; and/or functional mouth breathing. This study was conducted with on 414 subjects of both genders, from 2 to 16-years old. A team consisting of 3 speech-language pathologists, 1 pediatrician, 1allergist, and 1 otolaryngologist, evaluated the patients. Multidisciplinary clinical examinations were carried out (complete blood counting, X-rays, nasofibroscopy, audiometry). The two most commonly found etiologies were allergic rhinitis, followed by functional mouth breathing. Of the 414 patients in the study, 346 received a speech-language pathology evaluation. The most prevalent finding in this group of 346 subjects was the presence of orofacial myofunctional disorders. The most frequently orofacial myofunctional disorder identified in these subjects who also presented mouth breathing included: habitual open lips rest posture, low and forward tongue rest posture and lack of adequate muscle tone. There were also no statistically significant relationships identified between etiology and speech-language diagnosis. Therefore, the specific type of etiology of mouth breathing does not appear to contribute to the presence, type, or number of speech-language findings which may result from mouth breathing behavior.

Mouth breathing and speech disorders: A multidisciplinary evaluation based on the etiology

“…According to the multidisciplinary assessment, 53.2% of the 498 MB were classified as functional MB without obstructive reasons, which was not consistent with the previous study by Junqueira et al . [ 6 ] In contrast with the previous reports, individuals with MB had a lower rate of OMD (10%) and a greater incidence of combined OMD and speech impairments (81.7%) than those who were diagnosed as mouth breathers in earlier investigations. [ 6 ] This study also revealed that 10.6% of the participants had multiple concomitant speech impediments, which were inconsistent with the reports of Hitos et al .…”

“…[ 5 ] MB syndrome is a term used to describe the symptoms of mouth breathers, including fatigue, daytime sleepiness, failure to thrive, restless sleep, nocturnal enuresis, immature auditory processing, inadequate oxygenation of the brain, and learning impairments. [ 6 7 8 ] Due to its wide range of comorbidities, MB has long been a concern for healthcare providers.…”

“…One of the most common causes of chronic MB in children is allergic rhinitis (AR), which disrupts the normal growth of the facial skeleton and impairs overall mental wellbeing. [ 3 6 ] Additionally, adenoid hypertrophy (AH) and nasal septum deviation can cause blockage of the nasal airway. When MB is caused by long-term oral habits, muscular changes, or a transient inflammation of the nasal mucosa, it is referred to as functional MB.…”

“…The different forms of speech disturbances, such as articulation and voice disorders, are among the characteristics of MB that pose the most concern. [ 1 6 ] Speech of the mouth breathers is influenced by a multitude of factors, notably inappropriate tongue posture, malocclusion, and/or impairments in facial growth and development, which lead to structural anomalies in the oral cavity and flaccid facial muscles. They experience difficulties with bilabial (/p/,/b/,/m/) and fricative (/f/,/v/,/s/,/z/) phonemes.…”

Sleep Difficulties and Symptoms of Attention-deficit Hyperactivity Disorder in Children with Mouth Breathing

“…One study also found that both mouth breathing and ADHD can aggravate SDB, which, along with daytime sleepiness, can impair performance in school. 33 …”