S04: Mouth breathing, craniofacial morphology and myofunctional therapy intervention in pediatric OSA

S04: Mouth breathing, craniofacial morphology and myofunctional therapy intervention in pediatric OSA
Saturday, April 2811:15am-12:45pm | Room Bordeaux

Chairs: Marc R. Moeller (USA), Patrick McKeown (Ireland)

Swallowing analyses in breastfeeding and bottle feeding: Pilot studies to examine the relationship between swallowing and sleep in infants and neonates via videofluoscopy
Esther Bianchini (Brazil)

The correlation between mouth breathing and severity of SDB
Brigitte Fung (Hong Kong)

Rediscovering the relationship between mouth breathing in childhood and malocclusion: What has been understood for over 100 years
Kevin Boyd (USA)

Mouth breathing and craniofacial morphology in OSA pathogenesis: Orthodontic and myofunctional intervention with regard to nasal breathing
Stacey Quo (USA)

Myofunctional therapy by cortical or subcortical networks
Patrick Fellus (France)


Summary of symposium:
The emerging field of orofacial myofunctional therapy (OMT) has gained prominence as an adjunct treatment for sleep disordered breathing (Guimares 2009, Huang 2013, Camacho 2015,
Ieto 2015, Camacho 2017) yet the there is much more research needed to establish the field. The collection of phenotypes, clinical markers, and syndromes collectively referred to in the
literature as orofacial myofunctional disorders (OMDs) such as ankyloglossia (Huang 2015, Guilleminault 2016) and high narrow palate (Yoon 2017, Yoon 2017) and their connection to
morphological conditions phenotypically related to SDB along with the relationship of OMT addressing these conditions have helped build a case for the application of OMT in SDB while at
the same time calling attention to a great deal of more work necessary establish the field. The recent emergence of the key OMD of mouth breathing as a potentially critical clinical
marker in OSA phenotyping and treatment (Bonuck 2012, Guilleminault 2014, Guilleminault 2016, Torre 2017) has gained in prominence. The ease of simple lay person understanding of
mouth breathing and the potential for the craniofacial morphological consequences of mouth breathing both warrant a sense of urgency around further understanding and potential updates
to SDB screening tools to include this OMD. The lack of clarity around identification, definitions, and the therapeutic interventions to address it present a challenge.

From the above literature, the OMT objectives of establishing lip seal and nasal breathing have potentially significant implications in the treatment of and, perhaps, prevention of SDB, but not
enough is known about the mechanisms that could result in mouth breathing or the techniques, such as breathing reeducation as a part of OMT, to address them.

It is the intention of this symposium to understand further what is involved in the development of mouth breathing, its potential consequences in SDB, and the OMT mechanisms involved in
their resolution. From the establishment of swallowing patterns and their relationship to sleep to brain imaging to confirm stable neuroplastic stability, this symposium will explore novel
approaches and metrics around mouth breathing and SDB.

Learning Objectives:
Upon Completion of this CME activity, participants should be able to:
1 Appraise the correlation between mouth breathing and SDB
2 Recognize the role of breathing re-education as a part of orofacial myofunctional therapy as an adjunct treatment for SDB
3 Describe the potential role of mouth breathing in the onset of OSA

Target Audience:
Sleep physicians, ENTs, dentists, myofunctional therapists, psychologists, sleep technologists, respiratory therapists.