Orofacial Myofunctional Therapy
Orofacial myofunctional therapy (OMT) has emerged as an alternative and adjunct for the treatment of sleep-disordered breathing (SDB) in adults and children.
An expert team including Dr. Liu's mentor (Kushida) and colleagues (Camacho) performed a meta-analysis that included 15 studies with 237 patients. They report a mean AHI reduction from 28.0 ± 16.2/h to 18.6 ± 13.1/h. Sleepiness measured via ESS (156 patients) reduced from 12.71 ± 5.73 to 8.78 ± 5.80.
In Dr. Liu's clinical experience, implementing MFT before and/or after sleep surgery is promising for a faster return, and optimization of function. He considers pre- and post-surgical MFT as the prehab and rehab phases of treatment.
OMT visualized with endoscopy and EMG measurements
Around 2018, Dr. Liu started to explore endoscopic airway examination during MFT with Esther Bianchini and her team in Brazil. Esther is a world-renowned expert in MFT and OSA. The team also included dear ENT colleagues from Brazil (Dr. Eric Thuler, Dr. Mariane Yui, and Dr. Fabio Rabelo). MFT for the treatment of OSA has long been studied and performed rigorously in Brazil.
The video is one of many from the team's first study, where MFT exercises were performed with endoscopic visualization of the throat/pharyngeal muscles.
Myofunctional therapy is a non-surgical exercise program, so its risks are small. These are the ones to know about.
- Muscle soreness or fatigue
- The tongue, lips, cheeks or jaw may feel tired or sore in the first weeks, as with any new exercise. Your therapist adjusts the program.
- Jaw joint discomfort
- Some exercises load the jaw joint. Tell your therapist if clicking or pain starts, so the exercises can be changed.
- Results depend on practice
- Benefits build with regular exercise and can fade if the exercises stop.
- Not enough on its own for some
- For moderate or severe sleep apnea, therapy works best alongside other treatment, such as CPAP, an oral appliance or surgery. It should not delay treatment you need.