Orofacial Myofunctional Therapy to Treat Residual Obstructive Sleep Apnoea in Children Treated with Adenotonsillectomy and Maxillary Expansion: An Interventional Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: In children with residual obstructive sleep apnoea (OSA) despite combined adenotonsillectomy (TA) and semi-rapid maxillary expansion (SRME), the optimal further management remains unclear. This study evaluated the effect of a 12-month programme of orofacial myofunctional therapy (OMFT) on residual OSA in this population. Materials and Methods: In this retrospective cohort study, 80 children (aged 7–9 years) with polysomnography-confirmed residual OSA (respiratory disturbance index [RDI] ≥1 event/hour) after combined TA and SRME were followed for 12 months. Forty-one children completed a 12-month course of OMFT, comprising 24 fortnightly clinical sessions plus daily home exercises, and 39 did not, due to compliance concerns, cost or access barriers, or parental preference. Level 1 polysomnography (PSG) was performed at baseline (Time 3, post-both-interventions) and at 12-month follow-up (Time 4). Group differences in RDI at follow-up (RDIfinal) and change from baseline (dRDIfin) were compared using independent-samples t-tests. Results: Mean RDI at Time 3 (before the intervention) did not differ significantly between groups (OMFT 4.68±1.39 vs. control 4.21±1.99, P=0.21). At 12-month follow-up, mean RDIfinal was 0.49±0.60 events/hour in the OMFT group versus 5.26±1.77 in the control group (mean difference 4.77, 95% CI 4.19–5.35, P< 0.001; Cohen's d=3.64). RDI fell by a mean of 4.20±0.95 events/hour in the OMFT group, while the control group's RDI rose by 1.05±0.61 events/hour (mean difference 5.25, 95% CI 4.89–5.60, P< 0.001; Cohen's d=6.53). Conclusions: A 12-month OMFT programme was associated with near-normal respiratory indices in children with residual OSA after combined TA and SRME, while untreated residual OSA showed mild further deterioration. Given the non-randomised allocation, this finding should be interpreted as a strong association rather than a confirmed causal effect; a randomised trial is warranted.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm15197676
Language: English
Subfield: Physiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
OpenAlex ID: W7204998191