Université de Paris-Cité, AP-HP, Hôpital Robert Debré, Service de Physiologie Pédiatrique-Centre du Sommeil, INSERM NeuroDiderot, Paris, France.
AP-HP, Hôpital Robert Debré, Service de Stomatologie et Chirurgie Plastique, Paris, France.
J Sleep Res. 2024 Oct;33(5):e14175. doi: 10.1111/jsr.14175. Epub 2024 Feb 19.
This cross-sectional study aimed to assess the prevalence of atypical deglutition (tongue thrust) in children diagnosed with moderate to severe obstructive sleep apnea syndrome (OSAS) and to explore its associations, particularly in relation to the type of dentition (mixed or permanent). The study was conducted over a 5 year period at a paediatric hospital in Paris, France. Children aged 6-18 years with moderate to severe OSAS (apnea-hypopnea index ≥5/h) underwent a comprehensive evaluation, including the recording of demographic data, symptoms of snoring and breathing issues, and otolaryngology examination. The swallowing pattern was assessed and orthodontic evaluations were performed. Cephalometric radiography and pharyngometry tests (pharyngeal collapsibility was computed) were conducted. The study found a high prevalence of atypical deglutition in children with mixed 74% [56-87] or permanent 38% [25-51] dentition. In children with mixed dentition and atypical deglutition, the pharyngeal compliance and lower facial dimensions were increased. In children with permanent dentition, atypical deglutition was associated with more severe OSAS and a lower hyoid bone position. Independent of the type of dentition, atypical deglutition was associated with an increase in the apnea-hypopnea index, an increase in the lower facial dimension, increased pharyngeal compliance, and a more caudal hyoid bone position. Atypical deglutition was strongly associated with increased pharyngeal collapsibility, more severe OSAS and altered facial measurements in children. The findings suggest that identifying atypical deglutition in children with OSAS could help to guide a personalised therapeutic approach, including myofunctional therapy.
本横断面研究旨在评估诊断为中重度阻塞性睡眠呼吸暂停综合征（OSAS）的儿童中异常吞咽（舌推）的患病率，并探讨其相关性，尤其是与牙齿类型（混合或恒牙）的关系。该研究在法国巴黎的一家儿科医院进行，历时 5 年。6-18 岁中重度 OSAS（呼吸暂停-低通气指数≥5/h）患儿接受全面评估，包括记录人口统计学数据、打鼾和呼吸问题症状以及耳鼻喉科检查。评估吞咽模式并进行正畸评估。进行头颅侧位放射摄影和咽测压检查（计算咽腔塌陷度）。研究发现，混合牙列儿童异常吞咽的患病率较高，为 74%[56-87]，恒牙列儿童为 38%[25-51]。在混合牙列且存在异常吞咽的儿童中，咽腔顺应性和下面部尺寸增加。在恒牙列的儿童中，异常吞咽与更严重的 OSAS 和更低的舌骨位置有关。无论牙齿类型如何，异常吞咽均与呼吸暂停-低通气指数增加、下面部尺寸增加、咽腔顺应性增加和舌骨位置更靠后有关。异常吞咽与咽腔塌陷度增加、更严重的 OSAS 和面部测量值改变强烈相关。这些发现表明，在 OSAS 患儿中识别异常吞咽可能有助于指导个性化的治疗方法，包括肌功能治疗。
