Orofacial Gymnastics: An Innovative Adjunctive Treatment Approach for Adenoid Facies
Naval S Bawaskar, NG Toshniwal
INTRODUCTION: Restricted nasorespiratory function can exert a dramatic effect upon the development of the dentofacial complex. If this occurs during a period of active growth, the outcome is development of adenoid facies. Such patients characteristically manifest a vertically long lower third facial height, restricted patency of upper airway, and lip incompetence. This is a preliminary report of orofacial gymnastics using an oral screen and Yogic Pranayama exercises for evaluating the change in the adenoid tissue morphology, muscle response of the orbicularis oris muscle, and forced vital capacity (FVC) of the lungs. MATERIALS AND METHODS: A 6-month cross-sectional comparative study was done on 20 subjects (10 in control group and 10 in experimental group) (12 males and 8 females) with an age range of 12 to 14 years. Comparison was made at 0 and 6 months interval. The treatment response to orofacial exercises was checked cephalometrically (adenoid tissue analysis), electromyographically [maximum voluntary isometric contraction (MVIC) of lower fibers of orbicularis oris muscle], and spirometrically (FVC). The changes in the parameters were analyzed using Studentâ€™s unpaired t-test. RESULTS: Results showed statistically significant cephalometric changes in relation to reduction in the size of the adenoid tissue along with increase in the FVC, thereby increasing the patency of the upper airway. The electromyographic (EMG) assessment also showed statistically significant increase in activity of the orbicularis oris muscle. CONCLUSION: Orofacial gymnastics act efficiently and effectively to initiate an increase in the patency of the upper airway by reducing the size of the adenoid tissues and increasing the FVC of the lungs. It also brings about an increase in the EMG activity of the orbicularis oris muscle. Hence, instead of going for surgical removal of adenoid tissues, orofacial gymnastics can certainly help reduce the obstruction of the upper airway by reducing the size of the adenoid tissues and can be combined with any other form of orthodontic or orthopedic treatment modality. Orofacial gymnastics therapy should not be seen as a substitute for therapy with orthodontic or orthopedic devices but rather as an accessory indispensable in creating the elements needed for normal growth and development.
Adenoid, Gymnastics, Orofacial