Giulio Gasparini1, Gianmarco Saponaro1, Mattia Todaro1, Gabriele Ciasca2, Lorenzo Cigni3, Piero Doneddu1, Camillo Azzuni1, Enrico Foresta1, Paolo De Angelis4, Giorgio Barbera1, Roberta Gaia Parcianello1, Horia Vasile Hreniuc5, Alessandro Moro1. 1. Maxillofacial Surgery Unit, Faculty of Medicine, University Hospital 'A. Gemelli', Catholic University of the Sacred Heart, IRCCS, 00168 Rome, Italy. 2. Dipartimento di Neuroscienze, Sezione di Fisica, University Hospital 'A. Gemelli', Catholic University of the Sacred Heart, IRCCS, 00168 Rome, Italy. 3. Department of Odonto-Stomatology, Azienda Ospedaliera Valtellina e Valchiavenna, 23100 Sondrio, Italy. 4. Departement of Head, Division of Oral Surgery and Implantology, Neck and Sensory Organs, University Hospital 'A. Gemelli', Catholic University of the Sacred Heart, IRCCS, 00168 Rome, Italy. 5. Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy.
Abstract
PURPOSE: The use of a mandibular advancement device (MAD) in the treatment of obstructive sleep apnea (OSA) is a consolidated therapy. This study aimed to evaluate the predictive value of awake upper airways (UA) functional endoscopy in identifying the outcome of MAD therapy. METHODS: This observational prospective study included 30 adult OSA patients, all patients underwent pre-treatment awake UA functional endoscopy, during the exam subjects were instructed to advance their mandible maximally, and they were divided into three different groups according to the response of the soft tissue, group A (expansion), group B (stretch), group C (unchanged). The results of this test were used in combination with other noninvasive indexes to predict the treatment outcome in terms of apnea-hypopnea index (AHI) reduction. RESULTS: We found that a substantial AHI reduction occurred in group A and group B while e slight AHI reduction was measured in group C. CONCLUSION: Based on our experience the awake UA endoscopy is a valid prognostic exam for discriminating responder and non-responder patients; in addition our results indicate the possibility of predicting a range of post-treatment AHI index values.
PURPOSE: The use of a mandibular advancement device (MAD) in the treatment of obstructive sleep apnea (OSA) is a consolidated therapy. This study aimed to evaluate the predictive value of awake upper airways (UA) functional endoscopy in identifying the outcome of MAD therapy. METHODS: This observational prospective study included 30 adult OSA patients, all patients underwent pre-treatment awake UA functional endoscopy, during the exam subjects were instructed to advance their mandible maximally, and they were divided into three different groups according to the response of the soft tissue, group A (expansion), group B (stretch), group C (unchanged). The results of this test were used in combination with other noninvasive indexes to predict the treatment outcome in terms of apnea-hypopnea index (AHI) reduction. RESULTS: We found that a substantial AHI reduction occurred in group A and group B while e slight AHI reduction was measured in group C. CONCLUSION: Based on our experience the awake UA endoscopy is a valid prognostic exam for discriminating responder and non-responder patients; in addition our results indicate the possibility of predicting a range of post-treatment AHI index values.
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