Three-dimensional motion analysis of facial movement during verbal and nonverbal expressions in healthy subjects.

Functional impairments of facial expressions alter the quality of life and their quantitative analysis is key to describing and grading facial function and dysfunction. The aim of this investigation was to quantify 3D lip movements in a group of healthy young subjects. Lip movements during five repetitions of common and random sequences of vowels and nonverbal expressions were recorded using an optoelectronic 3D motion analyzer. The mean maximum displacement of facial landmarks was used to compute 3D unilateral mobility and the symmetry indices (SI) separately for each sex. Facial mobility was significantly greater during open-mouth than closed-mouth smiles. Facial movement among the subjects was largest during articulation of the vowel /a/ and smallest for /i/. Lips were pursed with a SI very close to 95%, while smiles were slightly more asymmetric. The vowel /a/ was articulated with significantly greater symmetry than /e/, /i/ and /u/. The outcomes suggest that the proposed method characterized normal facial animations satisfactorily, so it could be a useful tool for assessing patients with facial lesions and dentofacial deformities. Patient assessment would profit from this quantitative approach, which would reduce discrepancies among several clinical examinations. Clin. Anat. 29:991-997, 2016. © 2016 Wiley Periodicals, Inc.

Translation and cross-cultural adaptation of the protocol of orofacial myofunctional evaluation with scores for Italian Language.

UNLABELLED: The protocol of orofacial myofunctional evaluation with scores (OMES-protocol or AMIOFE in Portuguese language) is a validated instrument for the diagnosis of orofacial myofunctional disorders that can be used in clinical practice for speech-language pathologists. Because in the Italian language there is no validated tool for such purpose, this study was developed. PURPOSES: To translate and culturally adapt the OMES-protocol for Italian language and determine the normal score value in a group of young Italian adults. METHODS: The OMES-protocol was translated from English to Italian by three bilingual individuals. From these translations, a consensus version was prepared by a research committee (three speech therapists and one physician and submitted to a committee of judges composed by eight speech therapists experienced in the area. The authors of the original version verified and approved the Italian version of the protocol. The instrument was tested via evaluations of 40 young and grown-up Italians (age range: 18-56 years) performed by two speech therapists. A cutoff score, previously described, was used to determine the mean and standard deviation. RESULTS: The translation stage and the final Italian version of the OMES-protocol are shown. The mean of scores for individuals with and without orofacial myofunctional disorders were presented. CONCLUSION: The Italian version of the OMES-protocol was developed, translated, and cross-culturally adapted. Normal values for young and adult Italian subjects are presented.

Tradução e adaptação transcultural do protocolo de avaliação miofuncional orofacial com escores para a Língua Italiana / Translation and cross-cultural adaptation of the protocol of orofacial myofunctional evaluation with scores for Italian Language

RESUMO O protocolo de avaliação miofuncional orofacial com escores (protocolo AMIOFE) é um instrumento validado para o diagnóstico de distúrbios miofuncionais orofaciais que pode ser utilizado por fonoaudiólogos em sua prática clínica. O presente estudo foi desenvolvido porque não há um instrumento validado para esta finalidade em língua Italiana. Objetivos: traduzir e realizar a adaptação transcultural do protocolo AMIOFE para a língua italiana e determinar os valores dos escores de normalidade em um grupo de jovens e adultos italianos. Métodos: o protocolo AMIOFE foi traduzido da língua inglesa para a italiana por três indivíduos bilíngues. A partir dessas traduções, uma versão de consenso foi preparada por um comitê de pesquisa (três fonoaudiólogos e um médico) e submetida a um comitê de juízes, composto por oito fonoaudiólogos italianos experientes na área. Os autores da versão original verificaram e aprovaram a versão italiana do protocolo. O instrumento foi testado por meio de avaliações de 40 sujeitos italianos jovens e adultos (faixa etária entre 18 e 56 anos de idade), realizadas por dois fonoaudiólogos. O ponto de corte, previamente descrito, foi usado para determinar as médias e desvios-padrão. Resultados: a etapa de tradução e a versão final da versão italiana do protocolo AMIOFE foram apresentadas, bem como as médias dos escores para os sujeitos com e sem distúrbio miofuncional orofacial. Conclusão: a versão italiana do protocolo AMIOFE foi desenvolvida, traduzida e adaptada transculturalmente. Valores de normalidade para sujeitos italianos jovens e adultos foram apresentados.

ABSTRACT The protocol of orofacial myofunctional evaluation with scores (OMES-protocol or AMIOFE in Portuguese language) is a validated instrument for the diagnosis of orofacial myofunctional disorders that can be used in clinical practice for speech-language pathologists. Because in the Italian language there is no validated tool for such purpose, this study was developed. Purposes: To translate and culturally adapt the OMES-protocol for Italian language and determine the normal score value in a group of young Italian adults. Methods: The OMES-protocol was translated from English to Italian by three bilingual individuals. From these translations, a consensus version was prepared by a research committee (three speech therapists and one physician and submitted to a committee of judges composed by eight speech therapists experienced in the area. The authors of the original version verified and approved the Italian version of the protocol. The instrument was tested via evaluations of 40 young and grown-up Italians (age range: 18-56 years) performed by two speech therapists. A cutoff score, previously described, was used to determine the mean and standard deviation. Results: The translation stage and the final Italian version of the OMES-protocol are shown. The mean of scores for individuals with and without orofacial myofunctional disorders were presented. Conclusion: The Italian version of the OMES-protocol was developed, translated, and cross-culturally adapted. Normal values for young and adult Italian subjects are presented.

Validity and reliability of a protocol of orofacial myofunctional evaluation for patients with obstructive sleep apnea.

There is no standardized protocol for the clinical evaluation of orofacial components and functions in patients with obstructive sleep apnea. The aim of this study was to examine the validity, reliability, and psychometric properties of the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-expanded) in subjects with obstructive sleep apnea. Patients with obstructive sleep apnea and control subjects were evaluated, and the validity of OMES-expanded was tested by construct validity (i.e. the ability to discriminate orofacial status between apneic and control subjects) and criterion validity (i.e. correlation between OMES-expanded and a reference instrument). Construct validity was adequate; the apneic group showed significantly worse orofacial status than did control subjects. Criterion validity of OMES-expanded was good, as was its reliability. The OMES-expanded is valid and reliable for evaluating orofacial myofunctional disorders of patients with obstructive sleep apnea, with adequate psychometric properties. It may be useful to plan a therapeutic strategy and to determine whether the effects of therapy are related to improved muscle and orofacial functions.

Muscular and functional changes following adenotonsillectomy in children.

BACKGROUND: It is recognized that adenotonsillar hypertrophy leads to muscular and functional changes in face, and that adenotonsillectomy is associated to improvement in this condition. However, the ideal interval one should wait until this spontaneous recovery is not well defined, neither if this recovery is expected to be complete or partial. OBJECTIVE: To compare the muscular and functional changes in face of children prior and after adenotonsillectomy in a monthly evaluation. METHODS: 8 children aged from 4 to 6 years were prospectively studied. All patients underwent adenotonsillectomy, and were assessed before and monthly-after surgery up to 6 months, through the Protocol of Orofacial Myofunctional Evaluation with Scores (OMES). RESULTS: There was a progressive improvement in OMES score in all measured parameters, including the "mobility" and "posture" sub-tests; this improvement was significant at the first month after surgery. The sub-test "function" was not affected by surgery. Improvement continued from the first to the sixth month after surgery, although it was not significant between these two periods. Additionally, all parameters remained altered after the final evaluation at six months. There was a significant correlation between the improvement in "mobility" sub-test and in total score of OMES. CONCLUSION: We observed a partial recovery in facial muscular and functional changes following adenotonsillectomy, particularly during the first month after surgery. This improvement was especially observed in the "mobility" and "posture" sub-tests. We conclude that waiting for a spontaneous muscular and functional facial recovery during the first month post-operatively seems reasonable. Nevertheless, after this period, if the patient fails to achieve recovery, it may be advised that this child should undergo myofunctional therapy.

Predictors of uvulopalatopharyngoplasty success in the treatment of obstructive sleep apnea syndrome.

OBJECTIVE: Uvulopalatopharyngoplasty (UPPP) has been described as an option for treating obstructive sleep apnea syndrome (OSAS), with variable success rates. The main purpose of our study was to correlate UPPP success to craniofacial bony structure and orofacial muscles function. METHODS: Clinical variables, including body mass index (BMI), age, and preoperative apnea-hypopnea index (AHI); cephalometric measurements of the craniofacial region and hyoid bone position; and muscle function variables including clinical protocol and tongue strength measures were evaluated in 54 patients who underwent UPPP in the last 7years. The measurements were related to the success or failure of UPPP based on the results of preoperative and postoperative polysomnography (PSG). RESULTS: The variables BMI, preoperative AHI, and cephalometric measurements showed no influence on surgical success. The clinical muscle protocol also was similar between groups. However, the muscle strength of the anterior portion of the tongue was significantly greater in the group that showed surgical success compared to those with surgical failure. CONCLUSION: OSAS is a multifactorial disease and diagnostic symptom assessments should be individualized. In addition, special attention should be given to functional muscle alterations of the airways, as they might influence the evolution of the disease.

Bruxism in children with nasal obstruction.

INTRODUCTION: Bruxism is characterized by repeated tooth grinding or clenching. The condition can occur in all age ranges and in both genders, being related or not to other oral habits. OBJECTIVE: The objective of the present study was to investigate the occurrence of bruxism in children with nasal obstruction and to determine its association with other factors. METHODS: Sixty children with nasal obstruction seen at the Otorhinolaryngology Outpatient Clinic of the University Hospital of Ribeirão Preto participated in the study. The data were obtained using a pre-established questionnaire applied to the person responsible and by orofacial evaluation of the patient. The participants were divided into two groups: group with bruxism (GB) as reported by the relatives and with the presence of tooth wear detected by clinical evaluation, and group without bruxism (GWB), consisting of children with none of the two symptoms of bruxism mentioned above. RESULTS: The presence of bruxism exceeded its absence in the sample studied (65.22%). There was no significant difference (P<0.05) between groups regarding gender, phase of dentition, presence of hearing diseases, degree of malocclusion, or child behavior. CONCLUSION: Bruxism and deleterious oral habits such as biting behavior (objects, lips and nails) were significantly present, together with the absence of suction habits, in the children with nasal obstruction.

Alteracões auditivas relacionadas ao zumbido nos distúrbios otológicos e da articulacão têmporo-mandibular / Ear symptons related to tinnitus in otological and temporomandibular joint disorders

O objetivo da pesquisa foi comparar as características do zumbido apresentado por pacientes de desordens temporomandibulares (grupo DTM) e pacientes com afecçöes otoneurologicas (grupo HC). Pacientes em número de 60, sendo 30 de cada grupo, foram submetidos à anamnese, avaliaçäo clínica otorrinolaringológica e audiológica. Houve diferenças entre os grupos quanto à intensidade do zumbido e a queixa principal e os resultados audiológicos. No grupo HC, o zumbido era intenso, muito intenso e contínuo, as principais queixas eram as de diminuiçäo da audiçäo e dificuldade em compreender palavras, e os testes audiológicos estavam alterados. No grupo DTM, o zumbido era moderado e esporádico, as queixas principais eram otalgia e plenitude auricular, sem alteraçäes nos testes audiológicos. Estas diferenças entre os grupos nos fornecem índices para caracterizar cada grupo, auxiliando no diagnóstico diferencial