Huang YS, Guilleminault C. Pediatric obstructive sleep apnea and the critical role of
oral-facial growth: evidences.
Front Neurol 2013;
3:184. [PMID:
23346072 PMCID:
PMC3551039 DOI:
10.3389/fneur.2012.00184]
[Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 12/17/2012] [Indexed: 11/13/2022] Open
Abstract
AIMS
Review of evidence in support of an oral-facial growth impairment in the development of pediatric sleep apnea in non-obese children.
METHOD
Review of experimental data from infant monkeys with experimentally induced nasal resistance. Review of early historical data in the orthodontic literature indicating the abnormal oral-facial development associated with mouth breathing and nasal resistance. Review of the progressive demonstration of sleep-disordered-breathing (SDB) in children who underwent incomplete treatment of OSA with adenotonsillectomy, and demonstration of abnormal oral-facial anatomy that must often be treated in order for the resolution of OSA. Review of data of long-term recurrence of OSA and indication of oral-facial myofunctional dysfunction in association with the recurrence of OSA.
RESULTS
Presentation of prospective data on premature infants and SDB-treated children, supporting the concept of oral-facial hypotonia. Presentation of evidence supporting hypotonia as a primary element in the development of oral-facial anatomic abnormalities leading to abnormal breathing during sleep. Continuous interaction between oral-facial muscle tone, maxillary-mandibular growth and development of SDB. Role of myofunctional reeducation with orthodontics and elimination of upper airway soft tissue in the treatment of non-obese SDB children.
CONCLUSION
Pediatric OSA in non-obese children is a disorder of oral-facial growth.
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