Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital and University Taiwan, China.
Front Neurol. 2013 Jan 22;3:184. doi: 10.3389/fneur.2012.00184. eCollection 2012.
Review of evidence in support of an oral-facial growth impairment in the development of pediatric sleep apnea in non-obese children.
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.
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.
Pediatric OSA in non-obese children is a disorder of oral-facial growth.
回顾支持非肥胖儿童睡眠呼吸暂停中口腔面部生长发育受损的证据。
回顾婴儿猴子中因鼻腔阻力而导致的实验数据。回顾早期正畸文献中的历史数据，表明口呼吸和鼻腔阻力相关的口腔面部发育异常。回顾接受腺样体扁桃体切除术治疗不彻底的 OSA 儿童的睡眠呼吸障碍（SDB）的逐渐表现，并证明必须经常治疗异常口腔面部解剖结构，以解决 OSA。回顾 OSA 长期复发的数据，并表明与 OSA 复发相关的口腔面部肌功能障碍。
展示早产儿和 SDB 治疗儿童的前瞻性数据，支持口腔面部张力减退的概念。提供支持张力减退作为导致睡眠期间呼吸异常的口腔面部解剖异常发展的主要因素的证据。口腔面部肌肉张力、上颌下颌生长和 SDB 发展之间的持续相互作用。肌功能再教育在治疗非肥胖 SDB 儿童中的作用，以及正畸和消除上呼吸道软组织的作用。
非肥胖儿童的小儿 OSA 是一种口腔面部生长发育障碍。
