The role of sleep endoscopy in oral appliance therapy for obstructive sleep apnea
| Autor: | Michalis Tzakis, Kallirroi Lamprou, Evgenia Gogou, Eliana Samartzi, Ioannis Koutsourelakis, George Kontovazainitis |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Oral appliance Polysomnography Logistic regression Body Mass Index 03 medical and health sciences Upper airway surgery 0302 clinical medicine Orthodontic Appliances Internal medicine medicine Humans Hypnotics and Sedatives Treatment Failure 030223 otorhinolaryngology Sleep Apnea Obstructive medicine.diagnostic_test business.industry Endoscopy General Medicine Equipment Design Middle Aged medicine.disease Increased body mass index Obstructive sleep apnea Otorhinolaryngology Sleep endoscopy 030220 oncology & carcinogenesis Surgery Female Palate Soft business Body mass index |
| Zdroj: | Auris, nasus, larynx. 48(2) |
| ISSN: | 1879-1476 |
| Popis: | Objective Although oral appliance therapy is considered a validated treatment for obstructive sleep apnea, its therapeutic success varies significantly among patients. Drug-induced sleep endoscopy is often employed in order to identify candidates for upper airway surgery; however, it remains unknown whether its findings can be associated with success of oral appliance therapy. This study tested the hypothesis that drug-induced sleep endoscopy variables can predict the outcome of oral appliance therapy in obstructive sleep apnea patients. Methods Forty-nine obstructive sleep apnea patients [45 men; mean apnea-hypopnea index 25.3 ± 7.5 events/h; mean body mass index 28.2 ± 3.0 kg/m2] underwent drug-induced sleep endoscopy, followed by a one-month of oral appliance therapy, and subsequently a follow-up polysomnography to assess outcome. Results Thirty-three patients (67.3%) were responders and sixteen were non-responders (32.6%). Non-responders had a higher occurrence of complete or partial circumferential collapse at velum in comparison with responders. Multivariate logistic regression analysis revealed that, among baseline clinical and polysomnographic characteristics and sleep endoscopy findings, the presence of complete circumferential collapse at velum and increased body mass index were the only independent predictors of oral appliance therapy failure. Conclusion Drug-induced sleep endoscopy can be used to predict a higher likelihood of success to oral appliance therapy in obstructive sleep apnea patients. |
| Databáze: | OpenAIRE |
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