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Cephalometric, Muscular and Swallowing changes in patients with OSAS.

Valarelli LP1, Corradi AMB1, Grechi TH1, Eckeli AL2, Aragon DC3, Küpper DS1, Almeida LA2, Sander HH2, de Felício CM1, Trawitzki LVV1, Valera FCP1

Abstract

BACKGROUND:

Obstructive Sleep Apnea Syndrome (OSAS) is believed to be associated with craniofacial and neuromuscular changes, although the interplay among these variables still is poorly recognized.

OBJECTIVE:

to identify hyoid, muscular and swallowing changes associated with OSAS, and to correlate these alterations with OSAS severity.

METHODS:

Cross-sectional study, in a tertiary referral center. Seventy-two adult individuals participated in this study: 12 controls (without apnea) and 60 patients with apnea (mild, moderate and severe OSAS - 20 individuals in each group). All participants were initially evaluated by otorhinolaryngologist and neurologist and underwent polysomnography for OSAS stratification. Cephalometric data, clinical myofunctional status, and swallow videofluoroscopy exam were assessed. A hybrid effect model was used to analyze swallowing parameters; dependent variables were age, body mass index (BMI) and cephalometric measures.

RESULTS:

individuals with OSAS presented lower hyoid position and narrower posterior airway distance when compared to controls. These parameters correlated to OSAS severity. Additionally, OSAS patients exhibited significantly lower myofunctional scores. Both velum and hyoid contraction times were significantly lower in the OSAS group at videofluoroscopy, regardless of its severity. Premature leakage into pharynx was more common in OSAS groups. Laryngeal penetration phenomenon occurred only in two patients (both from OSAS group).

CONCLUSION:

our results suggest that hyoid bone position is associated with OSAS severity. Muscular pattern and swallowing are impaired in OSAS patients, irrespective of OSAS severity and facial profile. These findings indicate a higher predisposition of OSAS patients to a present an inferior hyoid positioning, accompanied by myofunctional and swallowing disorders. This article is protected by copyright. All rights reserved.