Mouth breathing, "nasal disuse," and pediatric XXXX .

@entity1 @entity31238 @entity387
BACKGROUND: Adenotonsillectomy (T_A) may not completely eliminate @entity387 ( @entity387 ), and residual @entity387 can result in progressive @entity387 . Persistence of mouth breathing post-T_As plays a role in progressive worsening through an increase of upper airway resistance during sleep with secondary impact on orofacial growth. METHODS: Retrospective study on non-overweight and non-syndromic prepubertal @entity1 with @entity387 treated by T_A with pre- and post-surgery clinical and polysomnographic (PSG) evaluations including systematic monitoring of mouth breathing (initial cohort). All @entity1 with mouth breathing were then referred for myofunctional treatment (MFT), with clinical follow-up 6  months later and @entity31238  year post-surgery. Only a limited subgroup followed the recommendations to undergo MFT with subsequent PSG (follow-up subgroup). RESULTS: Sixty-four prepubertal @entity1 meeting inclusion criteria for the initial cohort were investigated. There was significant symptomatic improvement in all @entity1 post-T_A, but 26 @entity1 had residual @entity387 with an AHI   >   1.5 events/hour and 35 @entity1 (including the previous 26) had evidence of "mouth breathing" during sleep as defined [minimum of 44  % and a maximum of 100  % of total sleep time, mean 69        11  % "mouth breather" subgroup and mean 4        3.9  %, range 0 and 10.3  % "non-mouth breathers"]. Eighteen @entity1 (follow-up cohort), all in the "mouth breathing" group, were investigated at 1  year follow-up with only nine having undergone 6  months of MFT. The non- MFT subjects were significantly worse than the MFT-treated cohort. MFT led to normalization of clinical and PSG findings. CONCLUSION: Assessment of mouth breathing during sleep should be systematically performed post-T_A and the persistence of mouth breathing should be treated with MFT.
