Speech therapy and orthognathic surgery: a literature review

Introduction: Dentofacial deformities are associated with changes in dental occlusion, which may cause changes in the myofunctional system according to the type of disproportion. These deformities can cause changes and/or adaptations in the stomatognathic system. The objective of this study was to identify the relationship between speech therapy and orthognathic surgery based on refereed publications. Method: A bibliographic survey was conducted without considering a specific publication period in the databases, PubMed, SciELO and BVS. Results: Fifteen articles were critically evaluated with respect to the type of study, objectives, number and sex of participants, methodology, results and conclusions. Based on their aims, the articles were grouped into 1) speech-therapy group (STG); 2) changes group (CG); 3) techniques group (GT) and 4) others group (OG). Conclusion: There is little information regarding direct speech therapy intervention, and the majority of the studies were directed to the aesthetic and functional changes in the hard and soft tissue in patients who underwent orthognathic surgery. Some studies addressed methods and/or specific examination procedures to verify the changes in the soft and hard tissues of the facial profile of patients who underwent orthognathic surgery, and a study detailed the profile of individuals who underwent treatment for dentofacial deformity and apnea-hypopnea syndrome

Mastigação e deglutição em indivíduos com obesidade indicados à realização de cirurgia bariátrica/gastroplastia - estudo piloto

Objetivo: descrever o padrão de mastigação e deglutição de indivíduos com obesidade, indicados à realização de cirurgia bariátrica/gastroplastia, antes do procedimento, por meio de protocolos clínicos padronizados. Métodos: trata-se de um estudo descritivo transversal, do tipo caso controle, que apresenta dados preliminares de um estudo maior. Oito participantes, divididos em quatro casos controle e quatro casos pesquisa, pareados por idade e gênero, foram submetidos a avaliação clínica fonoaudiológica por meio do “Questionário sobre comportamento alimentar e as condições anatomofuncionais do sistema estomatognático”, do protocolo AMIOFE-E e do teste de pressão máxima de língua. Resultados: os participantes dos casos pesquisa apresentaram em comparação aos casos controle: predominância de mastigação unilateral preferencial; referiram que apenas “engole o alimento”; repetição de deglutição em alimentos líquidos e sólidos, com presença de tensão dos músculos faciais; bochechas com volume aumentado e presença de flacidez; tempo de refeição e mastigação menores; tensão aumentada de lábios, músculos mentual e faciais no repouso e na deglutição; predominância de habilidade insuficiente com movimentos associados e/ou tremor nas tarefas de mobilidade de lábios, língua, mandíbula e bochechas; e desconhecimento da atuação fonoaudiológica. Conclusão: os pacientes do grupo pesquisa, apresentaram maior ocorrência de alterações miofuncionais orofaciais quando comparados ao grupo controle. Identifica-se a necessidade do aumento do número de participantes nesta série de casos, assim como a possibilidade de reavaliação no momento pós-cirúrgico visando uma descrição longitudinal do padrão de mastigação e deglutição.Objective: to describe the chewing and swallowing pattern of obese individuals indicated for bariatric surgery/gastroplasty before the procedure, using standardized clinical protocols. Methods: a cross-sectional descriptive case-control study that presents preliminary data for a larger investigation. Eight participants matched for age and sex were divided into two groups (four in the research group and four as controls) and submitted to clinical speech therapy assessment using the “Questionnaire on eating behavior and the anatomofunctional conditions of the stomatognathic system” from the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-E) and the maximum tongue pressure test. Results: when compared to controls, participants from the research group exhibited a predominantly unilateral chewing preference; reported that they just “swallowed food”; repeated swallowing of liquid and solid foods, with facial muscle tension; increased cheek volume and the presence of flaccidity; shorter meal and chewing times; increased tension of the lips, mentalis and facial muscles at rest and during swallowing; predominance of insufficient ability with associated movements and/or tremors during lip, tongue, jaw and cheek movements; and lack of knowledge regarding speech therapy. Conclusion: orofacial myofunctional dysfunctions were more frequent in patients from the research group when compared to controls. A need to increase the number of participants in this case series and conduct a post-surgery reassessment, in order to provide a longitudinal description of the chewing and swallowing pattern, was verified