International Journal of Orofacial Myology and Myofunctional Therapy

Background: Mouth breathing and obstructive sleep apnea (OSA) in children are interrelated conditions that can negatively impact neurocognitive development and overall quality of life. This study aimed to critically analyze the available evidence regarding the relationship between these conditions, highlighting their prevalence, clinical consequences, and therapeutic approaches. Methods: To this end, an umbrella review was conducted, including systematic reviews and meta-analyses retrieved from scientific databases, following rigorous inclusion criteria. Results: A total of six systematic reviews met the inclusion and exclusion criteria and were included in the final analysis. These studies explored various aspects of the topic and underwent a thorough assessment of methodological quality. Conclusions: The findings indicated that mouth breathing may act as both a predisposing and aggravating factor for OSA, while OSA itself may contribute to the persistence of this breathing pattern. However, the methodological heterogeneity among the included studies posed a challenge to synthesizing the findings, underscoring the need for more standardized research. It is concluded that early interventions and multidisciplinary approaches are essential for the effective management of these conditions. Furthermore, this review provides a foundation for future research in this area.

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Purpose: Ankyloglossia (tongue-tie) can lead to oromyofascial dysfunction which affects breathing, swallowing, speech, and posture. This study presents the evolution and outcomes of a refined lingual frenuloplasty protocol that integrates individualized myofunctional therapy to address compensatory patterns. Methods: A prospective cohort of 445 patients (≥4 years) was treated between 2021 and 2023 using a fascia-preserving CO₂ laser protocol with structured pre- and postoperative myofunctional therapy. Patients were stratified as pediatric (<12 years) or adolescent/adult (≥12 years). Key refinements included fascia-sparing dissection, reduced suture tension with cyanoacrylate adhesive, defined functional endpoints, structured myofunctional therapy, and standardized wound-healing strategies. Results: Among 379 patients (85% response) with >2 months follow-up, the 2025 protocol achieved an 86% satisfaction rate and significantly fewer complications compared with 2019 (pain 3.7% vs. 15.8%; bleeding 1% vs. 13%; revision 2.1% vs. 6.6%). Deeper genioglossus dissection increased swelling risk (OR = 4.0, p < 0.0001) but did not affect satisfaction. Conclusions: The refined 2025 protocol represents an outcome-tracked advancement in ankyloglossia management. By emphasizing fascia preservation, functional diagnostics, and integrated myofunctional therapy, the approach improves safety, efficacy, and patient-centered outcomes.