ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2020
Prevalence of malocclusions and oral dysfunctions in children with persistent sleep-disordered breathing after adenotonsillectomy in the long term.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Is Ankyloglossia Correlated With Pediatric Sleep Disordered Breathing? A Systematic Review.The Laryngoscope · 2026Pooled it
- Association between mouth breathing and pediatric obstructive sleep apnea: a systematic review.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Pooled it
- Relationship of ankyloglossia and obstructive sleep apnea: systematic review and meta-analysis.Sleep & breathing = Schlaf & Atmung · 2024Pooled it
- Lingual frenulum, craniofacial morphology, and obstructive sleep apnea: a mediation analysis.Sleep & breathing = Schlaf & Atmung · 2026Article
- Orthodontic Perspectives in the Interdisciplinary Management of Pediatric Obstructive Sleep Apnea.Children (Basel, Switzerland) · 2025Review
- Recurrence of Obstructive Sleep Apnea in Post-adenotonsillectomy Obese Pediatric Patients: A Systematic Review.Cureus · 2025Review
- Craniofacial anatomical determinants of pediatric sleep-disordered breathing: A comprehensive review.Journal of prosthodontics : official journal of the American College of Prosthodontists · 2025Review
- Mouth Breathing and Its Impact on Sleep Breathing Disorders in Children: A Cross-Sectional Study in Bandung, Indonesia.Clinical, cosmetic and investigational dentistry · 2025Article
- Comprehensive analysis of orofacial motor skills in children with obstructive sleep apnea.Sleep & breathing = Schlaf & Atmung · 2024Article
- A century of adenotonsillectomy's failure to fully resolve sleep-disordered breathing: mild malocclusions are maybe not so mild?Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesTo evaluate the prevalence of craniofacial/orthodontic abnormalities and oral dysfunctions in a population of children with persistent sleep-disordered breathing despite adenotonsillectomy.
methodsMedical charts of 4,000 children with sleep-disordered breathing operated on in a tertiary hospital were retrospectively reviewed. Patients reporting persistent sleep-disordered breathing symptoms were invited to an orthodontic/myofunctional evaluation following the Sleep Clinical Score), followed by a 1-night ambulatory type III sleep study.
resultsOne hundred nonsyndromic symptomatic patients were examined (mean age 8.8 ± 3.5 years), from 1 to 12 years after surgery (mean 4.6 ± 3.1 years); 24% were overweight/obese; 69 had a sleep study. Although prevalent, oronasal abnormalities and malocclusions were not specifically associated with pathological sleep parameters (cartilage hypotonia 18%, septal deviation 5%, short lingual frenulum 40%). Malocclusions were associated with a higher respiratory event index in children under 8 years only, whereas an impaired nasal dilator reflex and tongue immaturity were associated with an increased obstructive respiratory event index in all patients (1.72 ± 2.29 vs 0.72 ± 1.22 events/h, P = .011) and Respiratory Event Index, respectively (3.63 ± 3.63 vs 1.19 ± 1.19 events/h). Male sex, phenotype, nasal obstruction, oral breathing, and young age at surgery (< 3 years) were significantly related to higher respiratory event index. Using the Sleep Clinical Score > 6.5 cut-off, patients with persistent sleep apnea were significantly distinct from chronic snoring (2.72 ± 2.67 vs 0.58 ± 0.55, P < .01).
conclusionsOronasal anatomical and functional abnormalities were quite prevalent and various in persistent sleep-disordered breathing after adenotonsillectomy. Nasal disuse and tongue motor immaturity were associated with a higher obstructive respiratory event index in the long term, whereas craniofacial risk factors might have a more pronounced impact at younger age.
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