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THE EFFECT OF PHOTOBIOMODULATION ON OROFACIAL MYOFUNCTIONAL THERAPY IN A PATIENT WITH OBSTRUCTIVE SLEEP APNEA AND MODERATE SNORING: CASE REPORT Nivea Maria Rosa Vieira; Giovana Diaféria
Orofacial Myofunctional Therapy (TMO) performed by speech therapists in individuals with snoring and Obstructive Sleep Apnea, has been consecrated in the scientific environment since 2009 by Guimarães, K., 2012 by Diaféria, G., 2014 by Ieto, V. and in 2015 by Kayamori, F. Already, photobiomodulation, is a new feature in Speech Therapy, in which the first work dates from 2015 (França, FP, Coelho, JF and Alves, GAS) and so far, we have not found in the literature no studies using low power laser in OSA and snoring associated with BMT. Therefore, further studies are needed and that is why we started this research.
The objective of this study is to verify the effect of photobiomodulation on the speech therapy treatment for mild OSA and moderate snoring, in a case study.
SCGR patient, male, 53 years old, polysomnography with AHI: 12.2 / h, moderate to high intermittent snoring, sleep efficiency 88.1%, N3: 30.2%, REM: 19.4%, minimum SaO2 82 % and Micro Awakening Index at 17.7 / h. During sleep endoscopy, signs of previous nasal cavity surgery, multisegmental pharyngeal collapse with anteroposterior predominance in velopharyngeal and posterior laryngitis were found. The assessment and speech planning were based on the reference of Diaféria et al 2013 and 2017. For orofacial myofunctional assessment, the modified mallampati index, the quality of life scale and the snoring analog scale were considered. The speech therapy adapted to the patient addressed the lagged aspects of the evaluation, such as adequacy of orofacial functions, combined with strength, endurance and mobility exercises, to tone and rearrange the muscle groups of the oropharyngeal region, in addition to the use of laser and the ilib technique.
The results suggest that the orofacial muscles acquired strength and tonicity, with greater mobility in the palatine veil, tongue, and lateral and posterior pharyngeal regions, with a modified mallampati index reduction from 4 to 1.5; the quality of life scale from 4 to 3.2 and the analog snoring scale from 10 to 0.
We conclude that the effect of photobiomodulation associated with TMO potentiated the effect of short-term treatment, besides providing improvement in sleep and sleep. patient's well-being. We consider photobiomodulation as an efficient therapeutic resource and we hope that speech therapists will research more about it.
Speech Therapy, Orofacial Myofunctional Therapy, Photobiomodulation, lib technique, Obstructive Sleep Apnea, Snoring
Relato de Caso
Consultorio particular - Sao Paulo - Brasil
NIvea Maria Rosa Vieira, Giovana Diaferia