Matteo Cavaliere1, Pietro De Luca2, Carla De Santis1, Alfonso Scarpa2, Massimo Ralli3, Arianna Di Stadio4, Pasquale Viola5, Giuseppe Chiarella5, Claudia Cassandro6, Francesco Cassandro7. 1. Otolaryngology Department, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy. 2. Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy. 3. Department of Sense Organs, Sapienza University of Rome, Rome, Italy. 4. Department of Otolaryngology, University of Perugia, Italy Department of Otolaryngology University of Perugia Italy. 5. Department of Experimental and Clinical Medicine, Unit of Audiology and Phoniatrics, Magna Græcia University, Catanzaro, Italy. 6. Surgical Sceinces Department, University of Turin, Turin, ITaly. 7. Dentistry Unit, Department of Neurosciences, University "Federico II", Napoli, Italy.
Abstract
STUDY OBJECTIVES: Oral appliances have gained their place in the treatment of obstructive sleep apnea (OSA) where custom-made titratable mandibular advancement devices (MAD) have become the oral appliance of choice. This study aimed to asses the value of the drug-induced sleep endoscopy (DISE) using a MAD in the prediction of treatment outcome for OSAHS. METHODS: This is a prospective, single-center cohort study that enrolled sixty-six consecutive patients with diagnosed OSA (5 events/h < apnea-hypopnea index (AHI) < 50 events/h) to be treated with a custom-made titratable MAD. The patients were evaluated polysomnographically with the MAD in situ after the adaptation and titration period of 3 months. The associations between findings during DISE and treatment outcome were assessed. RESULTS: The subjects showed a wide range of severity of OSAHS pre-treatment: median AHI was 43.10 with a range from 20.13 to 66.07. The simulation bite was associated with a significant increase in cross-sectional area at level of the velopharynx, tongue base and epiglottis. MAD treatment response in the studied population was 91%, with a mean AHI improving from 43.10 to 12.93. CONCLUSIONS: Drug-induced sleep endoscopy with simulation bite is an acceptably reproducible technique for determining the sites of obstruction in OSAHS subjects; it thus offers possibilities as a prognostic indicator for treatment with MAD.
STUDY OBJECTIVES: Oral appliances have gained their place in the treatment of obstructive sleep apnea (OSA) where custom-made titratable mandibular advancement devices (MAD) have become the oral appliance of choice. This study aimed to asses the value of the drug-induced sleep endoscopy (DISE) using a MAD in the prediction of treatment outcome for OSAHS. METHODS: This is a prospective, single-center cohort study that enrolled sixty-six consecutive patients with diagnosed OSA (5 events/h < apnea-hypopnea index (AHI) < 50 events/h) to be treated with a custom-made titratable MAD. The patients were evaluated polysomnographically with the MAD in situ after the adaptation and titration period of 3 months. The associations between findings during DISE and treatment outcome were assessed. RESULTS: The subjects showed a wide range of severity of OSAHS pre-treatment: median AHI was 43.10 with a range from 20.13 to 66.07. The simulation bite was associated with a significant increase in cross-sectional area at level of the velopharynx, tongue base and epiglottis. MAD treatment response in the studied population was 91%, with a mean AHI improving from 43.10 to 12.93. CONCLUSIONS: Drug-induced sleep endoscopy with simulation bite is an acceptably reproducible technique for determining the sites of obstruction in OSAHS subjects; it thus offers possibilities as a prognostic indicator for treatment with MAD.
Authors: A S L Chan; R W W Lee; V K Srinivasan; M A Darendeliler; R R Grunstein; P A Cistulli Journal: Eur Respir J Date: 2009-09-24 Impact factor: 16.671
Authors: M Cavaliere; P De Luca; A Scarpa; L Savignano; C Cassandro; E Cassandro; M Iemma Journal: Eur Arch Otorhinolaryngol Date: 2020-05-04 Impact factor: 2.503
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Authors: Anneclaire V M T Vroegop; Olivier M Vanderveken; Marijke Dieltjens; Kristien Wouters; Vera Saldien; Marc J Braem; Paul H Van de Heyning Journal: J Sleep Res Date: 2012-12-04 Impact factor: 3.981