Is ankyloglossia associated with obstructive sleep apnea?

Bussi, Marieli Timpani; Corrêa, Camila de Castro; Cassettari, Arthur Justi; Giacomin, Lorena Torres; Faria, Ana Célia; Moreira, Ana Paula Sereni Manfredi; Magalhães, Itamá; Cunha, Mila Oliveira da; Weber, Silke Anna Theresa; Zancanella, Edilson; Machado Júnior, Almiro José

doi:10.1016/j.bjorl.2021.09.008

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Brazilian Journal of Otorhinolaryngology

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Sumário

Review article • Braz. j. otorhinolaryngol. 88 (Suppl 1) • 2022 • https://doi.org/10.1016/j.bjorl.2021.09.008 copy

Is ankyloglossia associated with obstructive sleep apnea?^☆ ☆ This article is part of the master's thesis of the Surgery Sciences Program at the Faculty of Medical Sciences of the State University of Campinas (UNICAMP).

Authorship SCIMAGO INSTITUTIONS RANKINGS

HIGHLIGHTS

An untreated shortened lingual frenulum at birth is associated with sleep apnea.

A shortened lingual frenulum alters the craniofacial growth with respiratory consequences.

Lingual frenuloplasty associated with myofunctional therapy is effective in the treatment of snoring.

In addition to improved sleep, there was an improvement in the speech and deglutition functions.

Abstract

Objectives

To investigate the evidence on the association between ankyloglossia and obstructive sleep apnea.

Methods

An integrative literature review was carried out in the databases. Observational and interventional studies that assessed the lingual frenulum in children with sleep-disordered breathing were included. As exclusion criteria: studies in animals, in vitro, letters to the editor, expert opinions, other reviews. The selected articles were analyzed regarding the study design, sample, characterization of the lingual frenulum and sleep assessment, in addition to the main results and conclusions.

Results

Ninety-seven articles were identified, but only 4 met the inclusion criteria. Two retrospective studies concluded that the untreated shortened lingual frenulum at birth is associated with obstructive sleep apnea. A prospective study concluded that there was an improvement in speech and deglutition after lingual frenectomy, in addition to improved sleep. A retrospective cohort concluded that lingual frenuloplasty combined with myofunctional therapy is effective in the treatment of snoring and mouth breathing.

Conclusion

The studies included in this review contribute to corroborate the association between ankyloglossia and obstructive sleep apnea.

Keywords
Ankyloglossia; Obstructive sleep apnea; Myofunctional therapy

PECOS
P articipants	Population
E xposition	Obstructive sleep apnea
C omparison	No comparison
O utcomes	Studies that performed the assessment of the lingual frenulum.
Types of S tudies	Observational and interventional studies

Database	Search	Initial findings
Pubmed	(“Sleep Apnea, Obstructive” [MeSH Terms] OR “Apneas, Obstructive Sleep” OR “Obstructive Sleep Apneas” OR “Sleep Apneas, Obstructive” OR “Obstructive Sleep Apnea Syndrome” OR “Obstructive Sleep Apnea” OR “OSAHS” OR “Syndrome, Sleep Apnea, Obstructive” OR “Sleep Apnea Syndrome, Obstructive” OR “Apnea, Obstructive Sleep” OR “Sleep Apnea Hypopnea Syndrome” OR “Syndrome, Obstructive Sleep Apnea” OR “Upper Airway Resistance Sleep Apnea Syndrome” OR “Syndrome, Upper Airway Resistance, Sleep Apnea” OR “OSA” OR “OSAS” OR “Sleep Apnea Syndromes” [MeSH Terms] OR “Apnea Syndrome, Sleep” OR “Apnea Syndromes, Sleep” OR “Sleep Apnea Syndrome” OR “Sleep Hypopnea” OR “Hypopnea, Sleep” OR “Hypopneas, Sleep” OR “Sleep Hypopneas” OR “Apnea, Sleep” OR “Apneas, Sleep” OR “Sleep Apnea” OR “Sleep Apneas” OR “Sleep Apnea, Mixed Central and Obstructive” OR “Mixed Central and Obstructive Sleep Apnea” OR “Sleep Apnea, Mixed” OR “Mixed Sleep Apnea” OR “Mixed Sleep Apneas” OR “Sleep Apneas, Mixed” OR “Hypersomnia with Periodic Respiration” OR “Sleep-Disordered Breathing” OR “Breathing, Sleep-Disordered” OR “Sleep Disordered Breathing”) AND (“Lingual Frenum” [MeSH Terms] OR “Lingual Frenulum” OR “Frenulum, Lingual” OR “Frenulums, Lingual” OR “Lingual Frenulums” OR “Frenum, Lingual” OR “Frenums, Lingual” OR “Lingual Frenums”)	10
Scopus	(“Sleep Apnea, Obstructive” OR “Apneas, Obstructive Sleep” OR “Obstructive Sleep Apneas” OR “Sleep Apneas, Obstructive” OR “Obstructive Sleep Apnea Syndrome” OR “Obstructive Sleep Apnea” OR “OSAHS” OR “Syndrome, Sleep Apnea, Obstructive” OR “Sleep Apnea Syndrome, Obstructive” OR “Apnea, Obstructive Sleep” OR “Sleep Apnea Hypopnea Syndrome” OR “Syndrome, Obstructive Sleep Apnea” OR “Upper Airway Resistance Sleep Apnea Syndrome” OR “Syndrome, Upper Airway Resistance, Sleep Apnea” OR “OSA” OR “OSAS” OR “Sleep Apnea Syndromes” OR “Apnea Syndrome, Sleep” OR “Apnea Syndromes, Sleep” OR “Sleep Apnea Syndrome” OR “Sleep Hypopnea” OR “Hypopnea, Sleep” OR “Hypopneas, Sleep” OR “Sleep Hypopneas” OR “Apnea, Sleep” OR “Apneas, Sleep” OR “Sleep Apnea” OR “Sleep Apneas” OR “Sleep Apnea, Mixed Central and Obstructive” OR “Mixed Central and Obstructive Sleep Apnea” OR “Sleep Apnea, Mixed” OR “Mixed Sleep Apnea” OR “Mixed Sleep Apneas” OR “Sleep Apneas, Mixed” OR “Hypersomnia with Periodic Respiration” OR “Sleep-Disordered Breathing” OR “Breathing, Sleep-Disordered” OR “Sleep Disordered Breathing”) AND (“Lingual Frenum” OR “Lingual Frenulum” OR “Frenulum, Lingual” OR “Frenulums, Lingual” OR “Lingual Frenulums” OR “Frenum, Lingual” OR “Frenums, Lingual” OR “Lingual Frenums”)	45
Embase	(‘sleep apnea, obstructive’/exp OR ‘sleep apnea, obstructive’ OR ‘apneas, obstructive sleep’ OR ‘obstructive sleep apneas’ OR ‘sleep apneas, obstructive’ OR ‘obstructive sleep apnea syndrome’/exp OR ‘obstructive sleep apnea syndrome’ OR ‘obstructive sleep apnea’/exp OR ‘obstructive sleep apnea’ OR ‘osahs’ OR ‘syndrome, sleep apnea, obstructive’ OR ‘sleep apnea syndrome, obstructive’ OR ‘apnea, obstructive sleep’ OR ‘sleep apnea hypopnea syndrome’/exp OR ‘sleep apnea hypopnea syndrome’ OR ‘syndrome, obstructive sleep apnea’ OR ‘upper airway resistance sleep apnea syndrome’ OR ‘syndrome, upper airway resistance, sleep apnea’ OR ‘osa’ OR ‘osas’ OR ‘sleep apnea syndromes’/exp OR ‘sleep apnea syndromes’ OR ‘apnea syndrome, sleep’ OR ‘apnea syndromes, sleep’ OR ‘sleep apnea syndrome’/exp OR ‘sleep apnea syndrome’ OR ‘sleep hypopnea’ OR ‘hypopnea, sleep’ OR ‘hypopneas, sleep' OR ‘sleep hypopneas’ OR ‘apnea, sleep’/exp OR ‘apnea, sleep’ OR ‘apneas, sleep’ OR ‘sleep apnea’/exp OR ‘sleep apnea’ OR ‘sleep apneas’ OR ‘sleep apnea, mixed central and obstructive’ OR ‘mixed central and obstructive sleep apnea’ OR ‘sleep apnea, mixed’ OR ‘mixed sleep apnea’ OR ‘mixed sleep apneas’ OR ‘sleep apneas, mixed’ OR ‘hypersomnia with periodic respiration’ OR ‘sleep-disordered breathing’/exp OR ‘sleep-disordered breathing’ OR ‘breathing, sleep-disordered’ OR ‘sleep disordered breathing’/exp OR ‘sleep disordered breathing’) AND (‘lingual frenum’/exp OR ‘lingual frenum’ OR ‘lingual frenulum’/exp OR ‘lingual frenulum’ OR ‘frenulum, lingual’/exp OR ‘frenulum, lingual’ OR ‘frenulums, lingual’ OR ‘lingual frenulums’ OR ‘frenum, lingual’ OR ‘frenums, lingual’ OR ‘lingual frenums’)	20
Web of Science	(“Sleep Apnea, Obstructive” OR “Apneas, Obstructive Sleep” OR “Obstructive Sleep Apneas” OR “Sleep Apneas, Obstructive” OR “Obstructive Sleep Apnea Syndrome” OR “Obstructive Sleep Apnea” OR “OSAHS” OR “Syndrome, Sleep Apnea, Obstructive” OR “Sleep Apnea Syndrome, Obstructive” OR “Apnea, Obstructive Sleep” OR “Sleep Apnea Hypopnea Syndrome” OR “Syndrome, Obstructive Sleep Apnea” OR “Upper Airway Resistance Sleep Apnea Syndrome” OR “Syndrome, Upper Airway Resistance, Sleep Apnea” OR “OSA” OR “OSAS” OR “Sleep Apnea Syndromes” OR “Apnea Syndrome, Sleep” OR “Apnea Syndromes, Sleep” OR “Sleep Apnea Syndrome” OR “Sleep Hypopnea” OR “Hypopnea, Sleep” OR “Hypopneas, Sleep” OR “Sleep Hypopneas” OR “Apnea, Sleep” OR “Apneas, Sleep” OR “Sleep Apnea” OR “Sleep Apneas” OR “Sleep Apnea, Mixed Central and Obstructive” OR “Mixed Central and Obstructive Sleep Apnea” OR “Sleep Apnea, Mixed” OR “Mixed Sleep Apnea” OR “Mixed Sleep Apneas” OR “Sleep Apneas, Mixed” OR “Hypersomnia with Periodic Respiration” OR “Sleep-Disordered Breathing” OR “Breathing, Sleep-Disordered” OR “Sleep Disordered Breathing”) AND (“Lingual Frenum” OR “Lingual Frenulum” OR “Frenulum, Lingual” OR “Frenulums, Lingual” OR “Lingual Frenulums” OR “Frenum, Lingual” OR “Frenums, Lingual” OR “Lingual Frenums”)	9
Lilacs	(“Sleep Apnea, Obstructive” OR “Apneas, Obstructive Sleep” OR “Obstructive Sleep Apneas” OR “Sleep Apneas, Obstructive” OR “Obstructive Sleep Apnea Syndrome” OR “Obstructive Sleep Apnea” OR “OSAHS” OR “Syndrome, Sleep Apnea, Obstructive” OR “Sleep Apnea Syndrome, Obstructive” OR “Apnea, Obstructive Sleep” OR “Sleep Apnea Hypopnea Syndrome” OR “Syndrome, Obstructive Sleep Apnea” OR “Upper Airway Resistance Sleep Apnea Syndrome” OR “Syndrome, Upper Airway Resistance, Sleep Apnea” OR “OSA” OR “OSAS” OR “Sleep Apnea Syndromes” OR “Apnea Syndrome, Sleep” OR “Apnea Syndromes, Sleep” OR “Sleep Apnea Syndrome” OR “Sleep Hypopnea” OR “Hypopnea, Sleep” OR “Hypopneas, Sleep” OR “Sleep Hypopneas” OR “Apnea, Sleep” OR “Apneas, Sleep” OR “Sleep Apnea” OR “Sleep Apneas” OR “Sleep Apnea, Mixed Central and Obstructive” OR “Mixed Central and Obstructive Sleep Apnea” OR “Sleep Apnea, Mixed” OR “Mixed Sleep Apnea” OR “Mixed Sleep Apneas” OR “Sleep Apneas, Mixed” OR “Hypersomnia with Periodic Respiration” OR “Sleep-Disordered Breathing” OR “Breathing, Sleep-Disordered” OR “Sleep Disordered Breathing” OR “Apneia Obstrutiva do Sono” OR “Apneia do Sono Obstrutiva” OR “Apneia do Sono Tipo Obstrutiva” OR “Síndrome da Apneia Obstrutiva do Sono” OR “Síndrome de Apneia do Sono por Resistência das Vias Aéreas Superiores” OR “Apnea Obstructiva del Sueño” OR “Síndromes da Apneia do Sono” OR “Apneia do Sono” OR “Hipersonia com Respiração Periódica” OR “Respiração Desordenada Durante o Sono” OR “Síndromes de la Apnea del Sueño”) AND (“Lingual Frenum” OR “Lingual Frenulum” OR “Frenulum, Lingual” OR “Frenulums, Lingual” OR “Lingual Frenulums” OR “Frenum, Lingual” OR “Frenums, Lingual” OR “Lingual Frenums” OR “Freio Lingual” OR “Frenillo Lingual” OR “Frênulo da Língua”)	3
ProQuest	(“Sleep Apnea, Obstructive” OR “Apneas, Obstructive Sleep” OR “Obstructive Sleep Apneas” OR “Sleep Apneas, Obstructive” OR “Obstructive Sleep Apnea Syndrome” OR “Obstructive Sleep Apnea” OR “OSAHS” OR “Syndrome, Sleep Apnea, Obstructive” OR “Sleep Apnea Syndrome, Obstructive” OR “Apnea, Obstructive Sleep” OR “Sleep Apnea Hypopnea Syndrome” OR “Syndrome, Obstructive Sleep Apnea” OR “Upper Airway Resistance Sleep Apnea Syndrome” OR “Syndrome, Upper Airway Resistance, Sleep Apnea” OR “OSA” OR “OSAS” OR “Sleep Apnea Syndromes” OR “Apnea Syndrome, Sleep” OR “Apnea Syndromes, Sleep” OR “Sleep Apnea Syndrome” OR “Sleep Hypopnea” OR “Hypopnea, Sleep” OR “Hypopneas, Sleep” OR “Sleep Hypopneas” OR “Apnea, Sleep” OR “Apneas, Sleep” OR “Sleep Apnea” OR “Sleep Apneas” OR “Sleep Apnea, Mixed Central and Obstructive” OR “Mixed Central and Obstructive Sleep Apnea” OR “Sleep Apnea, Mixed” OR “Mixed Sleep Apnea” OR “Mixed Sleep Apneas” OR “Sleep Apneas, Mixed” OR “Hypersomnia with Periodic Respiration” OR “Sleep-Disordered Breathing” OR “Breathing, Sleep-Disordered” OR “Sleep Disordered Breathing” OR “Apneia Obstrutiva do Sono” OR “Apneia do Sono Obstrutiva” OR “Apneia do Sono Tipo Obstrutiva” OR “Síndrome da Apneia Obstrutiva do Sono” OR “Síndrome de Apneia do Sono por Resistência das Vias Aéreas Superiores” OR “Apnea Obstructiva del Sueño” OR “Síndromes da Apneia do Sono” OR “Apneia do Sono” OR “Hipersonia com Respiração Periódica” OR “Respiração Desordenada Durante o Sono” OR “Síndromes de la Apnea del Sueño”) AND (“Lingual Frenum” OR “Lingual Frenulum” OR “Frenulum, Lingual” OR “Frenulums, Lingual” OR “Lingual Frenulums” OR “Frenum, Lingual” OR “Frenums, Lingual” OR “Lingual Frenums” OR “Freio Lingual” OR “Frenillo Lingual” OR “Frênulo da Língua”)	10

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[1] Peer Review under the responsibility of Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial.

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Is ankyloglossia associated with obstructive sleep apnea?☆ ☆ This article is part of the master's thesis of the Surgery Sciences Program at the Faculty of Medical Sciences of the State University of Campinas (UNICAMP).

HIGHLIGHTS

Abstract

Objectives

Methods

Results

Conclusion

Is ankyloglossia associated with obstructive sleep apnea?^☆ ☆ This article is part of the master's thesis of the Surgery Sciences Program at the Faculty of Medical Sciences of the State University of Campinas (UNICAMP).