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CC BY-NC-ND 4.0 · Sleep Sci 2022; 15(01): 95-104
DOI: 10.5935/1984-0063.20220030
ORIGINAL ARTICLE

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

Fabiane Kayamori 
1   Pontifícia Universidade Católica de São Paulo - PUC/SP, Programa de Pós Graduação em Fonoaudiologia - São Paulo - São Paulo - Brazil.
,
Fabio Augusto Winckler Rabelo
2   Hospital Samaritano, Departamento de Otorrinolaringologia - São Paulo - São Paulo - Brazil.
,
Daniella Nazario
3   EBianchini Fonoaudiologia, Consultório - São Paulo - São Paulo - Brazil.
,
Eric Rodrigues Thuller
4   Hospital Sírio-Libanês, Instituto Sírio-Libanês de Ensino e Pesquisa - São Paulo - São Paulo - Brazil.
,
Esther Mandelbaum Gonçalves Bianchini
1   Pontifícia Universidade Católica de São Paulo - PUC/SP, Programa de Pós Graduação em Fonoaudiologia - São Paulo - São Paulo - Brazil.
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ABSTRACT

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.

Keywords:

Sleep Apnea - Obstructive - Examination - Physical - Therapy - Speech


Publication History

Received: 13 December 2020

Accepted: 05 July 2021

Article published online:
01 December 2023

© 2022. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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