Impact of upper airway abnormalities on the success and adherence to mandibular advancement device treatment in patients with Obstructive Sleep Apnea Syndrome.

Autor:	Prescinotto R; Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Department of Otorhinolaryngology, Faculdade de Medicina do ABC, Santo André, SP, Brazil. Electronic address: prescinotto@hotmail.com., Haddad FL; Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil., Fukuchi I; Department of Otorhinolaryngology, Faculdade de Medicina do ABC, Santo André, SP, Brazil., Gregório LC; Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil., Cunali PA; Dentistry Course, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil; Department of Medicine and Sleep Biology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil., Tufik S; Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil., Bittencourt LR; Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Department of Medicine and Sleep Biology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
Jazyk:	angličtina
Zdroj:	Brazilian journal of otorhinolaryngology [Braz J Otorhinolaryngol] 2015 Nov-Dec; Vol. 81 (6), pp. 663-70. Date of Electronic Publication: 2015 Sep 07.
DOI:	10.1016/j.bjorl.2015.08.005
Abstrakt:	Introduction: The mandibular advancement device (MAD) is a option to treat patients with Obstructive Sleep Apnea Syndrome (OSAS). Objective: To assess the influence of upper airway abnormalities on the success of and adherence to MAD in patients with OSAS. Methods: Prospective study with 30 patients with mild to moderate OSAS and indications for MAD. The protocol included questionnaires addressing sleep and nasal complaints, polysomnography, and upper airway assessment. The analyzed parameters of patients who showed therapeutic success and failure and those who exhibited good and poor treatment adherence were compared. Results: 28 patients completed the protocol; 64.3% responded successfully to treatment with MAD, and 60.7% exhibited good adherence to treatment. Factors associated with greater success rates were younger age (p=0.02), smaller cervical circumference (p=0.05), and lower AHI at baseline (p=0.05). There was a predominance of patients without nasal abnormalities among patients treated successfully compared to those with treatment failure (p=0.04), which was not observed in relation to adherence. Neither pharyngeal nor facial skeletal abnormalities were significantly associated with either therapeutic success or adherence. Conclusion: MAD treatment success was significantly lower among patients with nasal abnormalities; however, treatment adherence was not influenced by the presence of upper airway or facial skeletal abnormalities. (Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.)
Databáze:	MEDLINE
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