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Myofunctional assessment for obstructive sleep apnea and the association with patterns of upper airway collapse: a preliminary study

OBJECTIVES: To organize an assessment instrument with questionnaires and myofunctional orofacial/oropharyngeal assessment for OSA patients and correlate it with the upper airway obstructive site detected during drug-induced sleep endoscopy (DISE). MATERIAL AND METHODS: 29 OSA patients aged 22-65 yea...

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Autores principales: Kayamori, Fabiane, Rabelo, Fabio Augusto Winckler, Nazario, Daniella, Thuller, Eric Rodrigues, Bianchini, Esther Mandelbaum Gonçalves
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Brazilian Association of Sleep and Latin American Federation of Sleep 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9153975/
https://www.ncbi.nlm.nih.gov/pubmed/35662973
http://dx.doi.org/10.5935/1984-0063.20220030
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author Kayamori, Fabiane
Rabelo, Fabio Augusto Winckler
Nazario, Daniella
Thuller, Eric Rodrigues
Bianchini, Esther Mandelbaum Gonçalves
author_facet Kayamori, Fabiane
Rabelo, Fabio Augusto Winckler
Nazario, Daniella
Thuller, Eric Rodrigues
Bianchini, Esther Mandelbaum Gonçalves
author_sort Kayamori, Fabiane
collection PubMed
description OBJECTIVES: To organize an assessment instrument with questionnaires and myofunctional orofacial/oropharyngeal assessment for OSA patients and correlate it with the upper airway obstructive site detected during drug-induced sleep endoscopy (DISE). MATERIAL AND METHODS: 29 OSA patients aged 22-65 years with an indication to undergo DISE to evaluate an alternative treatment to PAP and signed the consent form. Patients over 65 years old with maxillofacial deficiency and BMI>30 were excluded. The subjects answered the Pittsburgh, Berlin (snore), and Epworth questionnaires. The myofunctional orofacial/oropharyngeal assessment comprised soft palate, palatine pillars, and uvula (structure and mobility), tonsils (size), mandible (bony bases), hard palate (depth and width), tongue (posture, volume, width, and height), floor of mouth (mylohyoid), tongue suction and sustaining (mobility), “lowering of the back of the tongue” (stimulus), which were scored by three speech-language pathologists with expertise. DISE was scored according to VOTE classification. The statistical analysis (t-test) compared groups without and with obstruction in VOTE with questionnaires and myofunctional orofacial/oropharyngeal assessment. RESULTS: The following were significantly different: snoring frequency (p=0.03) with VOTE/velopharynx; intensity (p=0.02) and frequency of snoring (p=0.03) with VOTE/lateral wall of oropharynx; suction the tongue and sustain (p=0.02) with VOTE/velopharynx; hard palate depth (p=0.02) and width (p=0.05) with obstruction VOTE/epiglottis; tonsils volume (p=0.05) with VOTE/epiglottis; tongue posture (p=0.00) with obstruction VOTE/epiglottis; floor of the mouth (p=0.02) with VOTE/epiglottis. CONCLUSION: Higher snoring frequency and intensity was observed in patients with obstruction at the velopharynx and oropharyngeal lateral wall. Obstruction at the velopharynx was associated with poor tongue ability to suck the tongue against the hard palate. Obstruction at the epiglottis had structural and functional associations, including the oropharyngeal lateral wall, affected by the palatine tonsils size, depth and width of the hard palate, tongue position, and flaccidity of the floor of mouth. Considering that this is a preliminary study, the data should be carefully verified and not generalized.
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spelling pubmed-91539752022-06-02 Myofunctional assessment for obstructive sleep apnea and the association with patterns of upper airway collapse: a preliminary study Kayamori, Fabiane Rabelo, Fabio Augusto Winckler Nazario, Daniella Thuller, Eric Rodrigues Bianchini, Esther Mandelbaum Gonçalves Sleep Sci Original Article OBJECTIVES: To organize an assessment instrument with questionnaires and myofunctional orofacial/oropharyngeal assessment for OSA patients and correlate it with the upper airway obstructive site detected during drug-induced sleep endoscopy (DISE). MATERIAL AND METHODS: 29 OSA patients aged 22-65 years with an indication to undergo DISE to evaluate an alternative treatment to PAP and signed the consent form. Patients over 65 years old with maxillofacial deficiency and BMI>30 were excluded. The subjects answered the Pittsburgh, Berlin (snore), and Epworth questionnaires. The myofunctional orofacial/oropharyngeal assessment comprised soft palate, palatine pillars, and uvula (structure and mobility), tonsils (size), mandible (bony bases), hard palate (depth and width), tongue (posture, volume, width, and height), floor of mouth (mylohyoid), tongue suction and sustaining (mobility), “lowering of the back of the tongue” (stimulus), which were scored by three speech-language pathologists with expertise. DISE was scored according to VOTE classification. The statistical analysis (t-test) compared groups without and with obstruction in VOTE with questionnaires and myofunctional orofacial/oropharyngeal assessment. RESULTS: The following were significantly different: snoring frequency (p=0.03) with VOTE/velopharynx; intensity (p=0.02) and frequency of snoring (p=0.03) with VOTE/lateral wall of oropharynx; suction the tongue and sustain (p=0.02) with VOTE/velopharynx; hard palate depth (p=0.02) and width (p=0.05) with obstruction VOTE/epiglottis; tonsils volume (p=0.05) with VOTE/epiglottis; tongue posture (p=0.00) with obstruction VOTE/epiglottis; floor of the mouth (p=0.02) with VOTE/epiglottis. CONCLUSION: Higher snoring frequency and intensity was observed in patients with obstruction at the velopharynx and oropharyngeal lateral wall. Obstruction at the velopharynx was associated with poor tongue ability to suck the tongue against the hard palate. Obstruction at the epiglottis had structural and functional associations, including the oropharyngeal lateral wall, affected by the palatine tonsils size, depth and width of the hard palate, tongue position, and flaccidity of the floor of mouth. Considering that this is a preliminary study, the data should be carefully verified and not generalized. Brazilian Association of Sleep and Latin American Federation of Sleep 2022 /pmc/articles/PMC9153975/ /pubmed/35662973 http://dx.doi.org/10.5935/1984-0063.20220030 Text en https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kayamori, Fabiane
Rabelo, Fabio Augusto Winckler
Nazario, Daniella
Thuller, Eric Rodrigues
Bianchini, Esther Mandelbaum Gonçalves
Myofunctional assessment for obstructive sleep apnea and the association with patterns of upper airway collapse: a preliminary study
title Myofunctional assessment for obstructive sleep apnea and the association with patterns of upper airway collapse: a preliminary study
title_full Myofunctional assessment for obstructive sleep apnea and the association with patterns of upper airway collapse: a preliminary study
title_fullStr Myofunctional assessment for obstructive sleep apnea and the association with patterns of upper airway collapse: a preliminary study
title_full_unstemmed Myofunctional assessment for obstructive sleep apnea and the association with patterns of upper airway collapse: a preliminary study
title_short Myofunctional assessment for obstructive sleep apnea and the association with patterns of upper airway collapse: a preliminary study
title_sort myofunctional assessment for obstructive sleep apnea and the association with patterns of upper airway collapse: a preliminary study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9153975/
https://www.ncbi.nlm.nih.gov/pubmed/35662973
http://dx.doi.org/10.5935/1984-0063.20220030
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