Objective: OSAS is currently a relatively frequent multifactorial sleep disorder often associated with metabolic
dysfunction. This case study highlights the importance of creating a collaboration team of different specialists such
as a pediatrician, a dentist, a sleep specialist, an otolaryngologist and a speech therapist, which, in this case, was
essential to promote an early and comprehensive diagnosis, not only to limit and to prevent complications, but for a
better therapeutic management of the symptoms.
Case review: A 10-year-old girl who came in for orthodontic treatment was found to have signs and symptoms of
metabolic disorders including obesity, obstructive sleep apnea, breathing issues, transmissive hypoacusis and
orofacial dysfunctions. She was previously treated orthodontically without resolution of any symptoms. At that
point, instead of a “serial” approach, the girl was evaluated and then treated by a team of professionals who
addressed together her various metabolic, functional and structural issues.
Results: The integrated program of palatal expansion and myofunctional therapy, in particular, made it possible to
intervene on the skeletal structure and on the muscular function of this patient by promoting nasal respiration, a
balanced mastication, adequate mobility and muscle tone of the orofacial complex and of the oropharynx. The
improvement of the metabolic status was associated with better breathing and important weight loss.
Conclusion: A multidisciplinary approach seems to be the best strategy for solving cases of MetS (metabolic
syndromes) and concomitant OSAS in children. A key role is played by the orthodontist and the pediatrician, by
being able to intercept cases of OSAS in children and in adolescent and by being able to intervene directly on some
components such as palatal contraction.
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