Diagnostic Accuracy of an Orofacial Scale for the Detection of Orofacial Myofunctional Disorders in Patients With Obstructive Sleep Apnoea.

Abstract

Background: Patients with obstructive sleep apnoea (OSA) are known to have orofacial myofunctional disorders (OMD) compared to healthy individuals. Consequently, treatment with oropharyngeal exercises has shown promise in some OSA cases. However, this requires an adequate orofacial myofunctional evaluation.

Aims: To develop a concise and reliable scale including the most relevant items for the orofacial myofunctional evaluation of individuals with OSA. The Expanded Orofacial Myofunctional Evaluation with Scores (OMES-E) protocol was previously validated for this purpose. However, it has been criticised for its length, time-consuming nature and omission of certain items.

Materials & methods: Fifty adults diagnosed with OSA by polysomnography and 23 healthy adults were included. Based on the literature, additional items were incorporated into the OMES-E to enhance the evaluation (OMES-E Plus), with subsequent reliability analysis. A scale with fewer items was derived from the OMES-E Plus based on reliability and correlation analyses. Its accuracy, sensitivity and specificity were determined in a sample of 19 subjects with OSA and 19 without OSA (Control), matched for age and sex. Statistical analyses included Cronbach's alpha, item-total correlations and receiver operating characteristic curve analysis.

Results: The resulting new instrument, named the Orofacial Scale for Obstructive Sleep Apnoea (OFSOSA), comprises 31 items. The OFSOSA demonstrated significant discriminatory ability, with an area under the curve of 0.987, sensitivity of 95.5% and specificity of 93.7%.

Conclusion: The OFSOSA, a concise instrument for myofunctional orofacial evaluation, was developed and validated, showing excellent psychometric properties for diagnosing OMDs in OSA patients.