Oropharyngeal exercises to reduce symptoms of OSA after AT.

Maria Pia Villa, Luca Brasili, Alessandro Ferretti, Ottavio Vitelli, Jole Rabasco, Anna Rita Mazzotta, Nicoletta Pietropaoli, Susy Martella
Author Information
  1. Maria Pia Villa: Neuroscience, Mental Health and Sense Organs Department, Pediatric Sleep Disease Centre, S. Andrea Hospital, "Sapienza" University of Rome, Via Grottarossa 1035/1039, 00189, Rome, Italy, mariapia.villa@uniroma1.it.

Abstract

PURPOSE: This study evaluated the efficacy of oropharyngeal exercises in children with symptoms of obstructive sleep apnea syndrome (OSA) after adenotonsillectomy.
METHODS: Polysomnographic recordings were performed before adenotonsillectomy and 6 months after surgery. Patients with residual OSA (apnea-Hypopnea Index, AHI > 1 and persistence of respiratory symptoms) after adenotonsillectomy were randomized either to a group treated with oropharyngeal exercises (group 1) or to a control group (group 2). A morphofunctional evaluation with Glatzel and Rosenthal tests was performed before and after 2 months of exercises. All the subjects were re-evaluated after exercise through polysomnography and clinical evaluation. The improvement in OSA was defined by ΔAHI: (AHI at T1 - AHI at T2)/AHI at T1 × 100.
RESULTS: Group 1 was composed of 14 subjects (mean age, 6.01 ± 1.55) while group 2 was composed of 13 subjects (mean age, 5.76 ± 0.82). The AHI was 16.79 ± 9.34 before adenotonsillectomy and 4.72 ± 3.04 after surgery (p < 0.001). The ΔAHI was significantly higher in group 1 (58.01 %; range from 40.51 to 75.51 %) than in group 2 (6.96 %; range from -23.04 to 36.96 %). Morphofunctional evaluation demonstrated a reduction in oral breathing (p = 0.002), positive Glatzel test (p < 0.05), positive Rosenthal test (p < 0.05), and increased labial seal (p < 0.001), and lip tone (p < 0.05).
CONCLUSIONS: Oropharyngeal exercises may be considered as complementary therapy to adenotonsillectomy to effectively treat pediatric OSA.

References

  1. J Am Dent Assoc. 2011 Dec;142(12):1357-64 [PMID: 22130436]
  2. Eur Respir J. 2009 May;33(5):1077-84 [PMID: 19047310]
  3. Chest. 2004 Mar;125(3):872-8 [PMID: 15006944]
  4. Am J Respir Crit Care Med. 2005 Aug 1;172(3):364-70 [PMID: 15879419]
  5. Eur Respir J. 2013 Jun;41(6):1355-61 [PMID: 23018902]
  6. Prog Orthod. 2012 May;13(1):57-68 [PMID: 22583588]
  7. Laryngoscope. 2004 Mar;114(3):454-9 [PMID: 15091218]
  8. Ann Otol Rhinol Laryngol. 2010 Aug;119(8):506-13 [PMID: 20860275]
  9. Sleep. 2004 Aug 1;27(5):997-1019 [PMID: 15453561]
  10. Pediatrics. 2006 Jan;117(1):e61-6 [PMID: 16396849]
  11. Sleep. 2002 Feb 1;25(1):59-65 [PMID: 11833862]
  12. Am J Respir Crit Care Med. 2010 Sep 1;182(5):676-83 [PMID: 20448096]
  13. Sleep Med. 2010 Aug;11(7):714-20 [PMID: 20620107]
  14. Am J Respir Crit Care Med. 2002 May 15;165(10):1395-9 [PMID: 12016102]
  15. J Pediatr. 1984 Jul;105(1):10-4 [PMID: 6737123]
  16. Korean J Pediatr. 2010 Oct;53(10):863-71 [PMID: 21189956]
  17. J Am Acad Child Adolesc Psychiatry. 2001 May;40(5):508-15 [PMID: 11349694]
  18. Eur Respir J. 2003 Feb;21(2):248-52 [PMID: 12608437]
  19. Expert Rev Respir Med. 2011 Jun;5(3):425-40 [PMID: 21702663]
  20. Curr Opin Pediatr. 2008 Dec;20(6):654-8 [PMID: 19005334]
  21. Sleep Breath. 2011 May;15(2):179-84 [PMID: 21437777]
  22. Cleft Palate Craniofac J. 2013 Mar;50(2):242-8 [PMID: 22849635]
  23. Am Rev Respir Dis. 1992 Nov;146(5 Pt 1):1235-9 [PMID: 1443877]
  24. Am J Respir Crit Care Med. 2009 May 15;179(10):962-6 [PMID: 19234106]
  25. BMJ. 2006 Feb 4;332(7536):266-70 [PMID: 16377643]
  26. Sleep Med. 2013 Jun;14(6):518-25 [PMID: 23522724]
  27. Pediatrics. 2012 Sep;130(3):576-84 [PMID: 22926173]
  28. Cochrane Database Syst Rev. 2011 Jan 19;(1):CD007074 [PMID: 21249687]

MeSH Term

Adenoidectomy
Case-Control Studies
Child
Child, Preschool
Exercise Therapy
Female
Humans
Male
Oropharynx
Polysomnography
Postoperative Complications
Prospective Studies
Sleep Apnea, Obstructive
Tonsillectomy
Treatment Outcome

Word Cloud

Created with Highcharts 10.0.0groupexercisesOSAadenotonsillectomyp < 0symptoms12evaluationsubjects05oropharyngealperformedsurgeryGlatzelRosenthalAHIcomposedmeanage604001range96 %positivetestOropharyngealPURPOSE:studyevaluatedefficacychildrenobstructivesleepapneasyndromeMETHODS:Polysomnographicrecordings6 monthsPatientsresidualapnea-HypopneaIndexAHI > 1persistencerespiratoryrandomizedeithertreatedcontrolmorphofunctionaltests2 monthsre-evaluatedexercisepolysomnographyclinicalimprovementdefinedΔAHI:T1 - AHIT2/AHIT1 × 100RESULTS:Group1401 ± 15513576 ± 0821679 ± 934472 ± 3ΔAHIsignificantlyhigher5801 %40517551 %-2336Morphofunctionaldemonstratedreductionoralbreathingp = 0002increasedlabialsealliptoneCONCLUSIONS:mayconsideredcomplementarytherapyeffectivelytreatpediatricreduceAT

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