title: Oropharyngeal exercises to reduce symptoms of OSA after AT.
abstract: OBJECTIVE
  This study evaluated the efficacy of oropharyngeal exercises in children with symptoms of obstructive sleep apnea syndrome (OSA) after adenotonsillectomy.
  
  
  METHODS
  Polysomnographic recordings were performed before adenotonsillectomy and 6 months after surgery. Patients with residual OSA (apnea-Hypopnea Index, AHI > 1 and persistence of respiratory symptoms) after adenotonsillectomy were randomized either to a group treated with oropharyngeal exercises (group 1) or to a control group (group 2). A morphofunctional evaluation with Glatzel and Rosenthal tests was performed before and after 2 months of exercises. All the subjects were re-evaluated after exercise through polysomnography and clinical evaluation. The improvement in OSA was defined by ΔAHI: (AHI at T1 - AHI at T2)/AHI at T1 × 100.
  
  
  RESULTS
  Group 1 was composed of 14 subjects (mean age, 6.01 ± 1.55) while group 2 was composed of 13 subjects (mean age, 5.76 ± 0.82). The AHI was 16.79 ± 9.34 before adenotonsillectomy and 4.72 ± 3.04 after surgery (p < 0.001). The ΔAHI was significantly higher in group 1 (58.01 %; range from 40.51 to 75.51 %) than in group 2 (6.96 %; range from -23.04 to 36.96 %). Morphofunctional evaluation demonstrated a reduction in oral breathing (p = 0.002), positive Glatzel test (p < 0.05), positive Rosenthal test (p < 0.05), and increased labial seal (p < 0.001), and lip tone (p < 0.05).
  
  
  CONCLUSIONS
  Oropharyngeal exercises may be considered as complementary therapy to adenotonsillectomy to effectively treat pediatric OSA.
authors.affiliation: Neuroscience, Mental Health and Sense Organs Department, Pediatric Sleep Disease Centre, S. Andrea Hospital, "Sapienza" University of Rome, Via Grottarossa 1035/1039, 00189, Rome, Italy, mariapia.villa@uniroma1.it.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Villa
authors.forename: Luca
authors.initials: L
authors.lastname: Brasili
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ferretti
authors.forename: Ottavio
authors.initials: O
authors.lastname: Vitelli
authors.forename: Jole
authors.initials: J
authors.lastname: Rabasco
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Mazzotta
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Pietropaoli
authors.forename: Susy
authors.initials: S
authors.lastname: Martella
mesh_terms: D000233:Adenoidectomy; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D009960:Oropharynx / Q000503:physiopathology*; D017286:Polysomnography; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology* / Q000534:rehabilitation*; D014068:Tonsillectomy; D016896:Treatment Outcome