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Acta Otorrinolaringológica Española Cross-cultural adaptation of the expanded protocol of orofacial myofunctional ev...
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Available online 25 March 2026

Cross-cultural adaptation of the expanded protocol of orofacial myofunctional evaluation with scores protocol for Spanish-speaking populations

Adaptación transcultural del Protocolo Ampliado de Evaluación Miofuncional Orofacial con Puntuaciones para poblaciones hispanohablantes
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Gislaine Aparecida Folhaa,b,
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gislainefolha@fmrp.usp.br

Corresponding author.
, Cláudia Maria de Felíciob,c, Carlos O'Connor-Reinad, Giédre Berretin-Felixe, Felipe Inostroza-Allendee,f, Spanish version of the OMES-E protocol
a Health Sciences Department, School of Medicine, Ribeirão Preto, University of São Paulo, Brazil
b Craniofacial Research Support Center, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
c Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine, Ribeirão Preto, University of São Paulo, Brazil
d Hospital Quironsalud Marbella, Marbella (Malaga), Spain
e Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, University of São Paulo, Bauru (São Paulo), Brazil
f Department of Speech, Language, and Hearing Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
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Abstract
Introduction

Orofacial myofunctional disorders are common, especially among individuals with sleep-disordered breathing, particularly those with obstructive sleep apnea. Reliable assessment tools are essential to identify and characterize these dysfunctions across different populations. However, the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-E), widely used in research and clinical settings, has not yet been available in Spanish.

Thus, this study aims to translate and culturally adapt the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-E) for use in Spanish-speaking populations.

Methods

The cross-cultural adaptation process followed the fourth stages of the methodology proposed by Beaton et al. (2000), including independent forward translations, synthesis, back-translation, expert committee review, and final approval. The expert panel included clinicians and researchers from various Spanish-speaking countries.

Results

Discrepancies in terminology and interpretation were resolved through consensus. Back-translations confirmed semantic consistency with the original. The expert review panel rated the Spanish version highly for clarity, cultural appropriateness, and conceptual equivalence. The final version preserved the structure and intent of the original protocol.

Conclusion

This study provides the first cross-culturally adapted Spanish version of the OMES-E protocol, preserving the conceptual integrity and operational structure of the original instrument. While this version is ready for initial clinical and research use, future studies are required to establish its psychometric properties in Spanish-speaking populations.

Keywords:
Obstructive sleep apnea
Stomatognathic system
Translation process
Validation studies
Myofunctional therapy
Resumen
Introducción

Los trastornos miofuncionales orofaciales son frecuentes, especialmente en personas con trastornos respiratorios del sueño, en particular aquellas con apnea obstructiva del sueño. Las herramientas de evaluación fiables son esenciales para identificar y caracterizar estas disfunciones en distintas poblaciones. Sin embargo, el Protocolo Ampliado de Evaluación Miofuncional Orofacial con Puntuaciones (OMES-E), ampliamente utilizado en investigación y en la práctica clínica, aún no estaba disponible en español. Así, este estudio tiene como objetivo traducir y adaptar culturalmente el OMES-E para su uso en poblaciones hispanohablantes.

Métodos

El proceso de adaptación transcultural siguió las cuatro primeras etapas de la metodología propuesta por Beaton et al. (2000), que incluyeron traducciones directas independientes, síntesis, retrotraducción, revisión por un comité de expertos y aprobación final. El panel de expertos estuvo conformado por clínicos e investigadores de diversos países hispanohablantes.

Resultados

Las discrepancias terminológicas y de interpretación se resolvieron por consenso. Las retrotraducciones confirmaron la consistencia semántica con la versión original. El comité de expertos calificó la versión en español con puntuaciones elevadas en cuanto a claridad, adecuación cultural y equivalencia conceptual. La versión final preservó la estructura y la intención del protocolo original.

Conclusión

Este estudio presenta la primera versión en español del protocolo OMES-E adaptada transculturalmente, manteniendo la integridad conceptual y la estructura operativa del instrumento original. Aunque esta versión está lista para su uso inicial en contextos clínicos y de investigación, se requieren estudios futuros para establecer sus propiedades psicométricas en poblaciones hispanohablantes.

Palabras clave:
Apnea obstructiva del sueño
Sistema estomatognático
Proceso de traducción
Estudios de validación
Terapia miofuncional

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