Dados do Trabalho

Título

MASTICATION AND DEGLUTITION IN CHILDREN WITH DOWN SYNDROME AND OBSTRUCTIVE SLEEP APNEA

Introdução

Down Syndrome or Trisomy 21 is the most common genetic disorder. The extra chromosome leads to some physical traits. Due to their specific craniofacial position, low muscle tone besides obesity and macroglossia, Down Syndrome is an important risk factor to Obstructive Sleep Apnea. However, the oral functions are not evaluated routinely, especially in children.

Objetivo

The study aimed to evaluate the short orofacial myofunctional protocol (ShOM) in Down Syndrome (DS) children and correlate it to polysomnographic results.

Métodos

The study was approved by the local ethics commission. All DS children of the pediatric ambulatory were invited to perform full-night polysomnography, independently of respiratory complaints as snoring or observed apneas. At the time of the exam, all children performed the short orofacial myofunctional protocol exam ShOM, which classifies respiratory pattern, competency, and tonus of the lips, the position of the tongue, deglutition, Rosenthal test, with a score varying from 0 to 7.

Resultados

16 Down Syndrome children, 8 girls, aged 4 to 15 years old, mean age 9.2 years, were included. All except one were diagnosed Obstructive Sleep Apnea (OSA), 8 had severe and 6 moderate. The mean ShOM score was 5.9 (± 1. 14). 13 (81,25%) children had oral breathing, 14 (93,33%) a positive Rosenthal test, 8 (53,33 %) had a high archer palate, 9 (56,25%) showed disorders in lip competence and 14 (93,33%) in lip tonus, tongue posture was erroneous in 14 (87,5%). Mastication was classified altered in 15 children. 11 (73,33%) performed anterior type, trituration on the incisors. Some of other behaviors and signs analyzed was altered posture of the head in 10 children (66,66%) and food escape was observed in 11 (73,33%). Disorders in deglutition were found in 15 children. 11 (88,75%) children showed light lips contraction, 12 (75%) had tongue interposed between teeth, 15 (93,75%) exhibited tension of the facial musculature, 12 (75%) food escape, 4 (25%) showed choking and noise. ShOM scores rates 6 and 7 correlated to severe OSA (Pearson correlation coefficient p=0,0584).

Conclusões

Almost all Down syndrome children showed disorders in mastication and deglutition, ShOM higher scores being associated to severe OSA. Orofacial myofunctional evaluation may help to identify different phenotypes in Down syndrome children with OSA like in non-syndromic ones, enhancing the need for a multidisciplinary approach.

Palavras -chave

Down Syndrome, Obstructive Sleep Apnea, children, mastication, deglutition