Villa Maria Pia, Brasili Luca, Ferretti Alessandro, Vitelli Ottavio, Rabasco Jole, Mazzotta Anna Rita, Pietropaoli Nicoletta, Martella Susy
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,
Sleep Breath. 2015 Mar;19(1):281-9. doi: 10.1007/s11325-014-1011-z. Epub 2014 May 26.
This study evaluated the efficacy of oropharyngeal exercises in children with symptoms of obstructive sleep apnea syndrome (OSA) after adenotonsillectomy.
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.
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).
Oropharyngeal exercises may be considered as complementary therapy to adenotonsillectomy to effectively treat pediatric OSA.
本研究评估了口咽锻炼对腺样体扁桃体切除术后出现阻塞性睡眠呼吸暂停综合征（OSA）症状儿童的疗效。
在腺样体扁桃体切除术前及术后6个月进行多导睡眠图记录。腺样体扁桃体切除术后仍有OSA（呼吸暂停低通气指数，AHI＞1且呼吸道症状持续存在）的患者被随机分为接受口咽锻炼治疗的组（1组）或对照组（2组）。在锻炼2个月前后进行Glatzel和Rosenthal测试的形态功能评估。锻炼后通过多导睡眠图和临床评估对所有受试者进行重新评估。OSA的改善通过ΔAHI定义：（T1时的AHI - T2时的AHI）/T1时的AHI×100。
1组由14名受试者组成（平均年龄，6.01±1.55），而2组由13名受试者组成（平均年龄，5.76±0.82）。腺样体扁桃体切除术前AHI为16.79±9.34，术后为4.72±3.04（p＜0.001）。1组的ΔAHI（58.01%；范围为40.51%至75.51%）显著高于2组（6.96%；范围为 - 23.04%至36.96%）。形态功能评估显示口呼吸减少（p = 0.002）、Glatzel测试阳性（p＜0.05）、Rosenthal测试阳性（p＜0.05）、唇闭合增加（p＜0.001）和唇张力增加（p＜0.05）。
口咽锻炼可被视为腺样体扁桃体切除术的辅助治疗方法，以有效治疗儿童OSA。
