The Efficacy of Oral Appliances in the Treatment of Persistent Sleep Apnea After Uvulopalatopharyngoplasty
| Autor: | Cynthia L. Rosenberg, Alice E. Bonitati, Richard P. Millman, Douglas M. Kahn, Carol C. Carlisle, Naomi R. Kramer |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Oral apparatus medicine.medical_specialty Polysomnography medicine.medical_treatment Oral appliance Critical Care and Intensive Care Medicine Uvulopalatoplasty Sleep Apnea Syndromes stomatognathic system Orthodontic Appliances Removable medicine Humans Treatment Failure Retrospective Studies medicine.diagnostic_test Palate business.industry Uvulopalatopharyngoplasty Apnea Sleep apnea Middle Aged medicine.disease nervous system diseases respiratory tract diseases Surgery Obstructive sleep apnea Treatment Outcome Uvula Anesthesia Pharynx Female medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Chest. 113:992-996 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.113.4.992 |
| Popis: | Twenty-four patients who failed uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea (OSA) had an adjustable oral (Herbst) appliance made to treat the persistent apnea. Six patients discontinued the device prior to sleep evaluation. Eighteen patients had polysomnographic evaluations at baseline, post-UPPP, and with the Herbst appliance in place. The apnea-hypopnea index baseline (AHI) and arterial oxygen saturation (SaO2) nadir were 42.3+/-6.1 and 83.6+/-1.8%, respectively. There was no significant change in either parameter with surgery. With the oral appliance, the AHI fell to 15.3+/-4.4 (por = 0.01) and the SaO2 nadir increased to 87.9+/-1.2% (por = 0.05). Ten of the patients had control of the OSA with the Herbst appliance with a fall in the AHI to10. There were, in addition, two partial responders as defined by an AHI of20 and a50% fall in AHI compared with baseline and post-UPPP values. All but one of the responders and partial responders had complete resolution of subjective symptoms of daytime sleepiness with the appliance. An adjustable oral appliance appears to be an effective mode of therapy to control OSA after an unsuccessful UPPP. |
| Databáze: | OpenAIRE |
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