Govardhan Chirag, Murdock Janine, Norouz-Knutsen Leyli, Valcu-Pinkerton Sanda, Zaghi Soroush
The Breathe Institute, Los Angeles, CA, USA.
South County Pediatric Speech, Mission Viejo, CA, USA.
Case Rep Otolaryngol. 2019 Mar 10;2019:3408053. doi: 10.1155/2019/3408053. eCollection 2019.
Chronic mouth breathing may adversely affect craniofacial development in children and may result in anatomical changes that directly impact the stability and collapsibility of the upper airway during sleep. Mouth breathing is a multifactorial problem that can be attributed to structural, functional, and neurological etiologies, which are not all mutually exclusive. While therapeutic interventions (myofunctional, speech and swallowing, occupational, and craniosacral therapy) may address the functional and behavioral factors that contribute to mouth breathing, progress may sometimes be limited by restrictive lingual and labial frenum that interfere with tongue and lip mobility. This case report explores the case of a three-year-old girl with mouth breathing, snoring, noisy breathing, and oral phase dysphagia that was successfully treated with lingual and labial frenuloplasty as an adjunct to myofunctional therapy. Within four days of the procedure, the patient had stopped snoring and demonstrated complete resolution of open mouth breathing. The patient was also observed to have increased compliance with myofunctional therapy exercises. This report highlights the effectiveness of surgical interventions to improve the efficacy of myofunctional therapy in addressing open mouth posture and low tongue resting position.
长期口呼吸可能会对儿童的颅面发育产生不利影响,并可能导致解剖结构变化,直接影响睡眠期间上呼吸道的稳定性和塌陷性。口呼吸是一个多因素问题,可归因于结构、功能和神经学病因,这些病因并非相互排斥。虽然治疗干预措施(肌功能、言语和吞咽、职业和颅骶疗法)可能解决导致口呼吸的功能和行为因素,但有时进展可能会受到限制舌系带和唇系带过短的影响,这会干扰舌头和嘴唇的活动。本病例报告探讨了一名三岁女童的病例,她有口呼吸、打鼾、呼吸嘈杂和口腔期吞咽困难的症状,通过舌系带和唇系带成形术作为肌功能治疗的辅助手段成功治愈。在手术后四天内,患者停止打鼾,并完全解决了张口呼吸问题。还观察到患者对肌功能治疗练习的依从性有所提高。本报告强调了手术干预在提高肌功能治疗解决张口姿势和低舌休息位疗效方面的有效性。