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

Prescinotto, Renato; Haddad, Fernanda Louise Martinho; Fukuchi, Ilana; Gregório, Luiz Carlos; Cunali, Paulo Afonso; Tufik, Sérgio; Bittencourt, Lia

doi:10.1016/j.bjorl.2015.08.005

Cited by 10 publications

(3 citation statements)

References 20 publications

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“…Compared to CPAP, these devices have the advantage of being unobtrusive, make no noise and are potentially less expensive, and are generally preferred by patients. Prescinotto et al reported a success rate of 64.3% using MAD 92 . Nevertheless, they may be associated with some adverse effects: among these, one that occurs in practically every individual who wears a MAD for a prolonged period of time is tooth movement 93 .…”

Section: Mandibular Advancement Devices (Mad)mentioning

confidence: 99%

Obstructive sleep apnoea/hypopnoea syndrome: relationship with obesity and management in obese patients

Salzano

Maglitto

Bisogno

et al. 2021

Acta Otorhinolaryngol Ital

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Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is a disease characterised by upper airway obstruction during sleep, quite frequent in the general population, even if underestimated. Snoring, sleep apnoea and diurnal hypersomnia are common in these patients. Central obesity plays a key role: it reduces the size and changes the conformation of the upper airways, besides preventing lung expansion, with consequent reduction of lung volumes. Furthermore, obese people are also resistant to leptin, which physiologically stimulates ventilation; as a result, this causes scarce awakening during apnoea. OSAHS diagnosis is based on the combination of clinical parameters, such as apnoea/hypopnoea index (AHI), medical history, physical examination and Mallampati score. The first objective reference method to identify OSAHS is polysomnography followed by sleep endoscopy. Therapy provides in the first instance reduction of body weight, followed by continuous positive airway pressure (CPAP), which still remains the treatment of choice in most patients, mandibular advancement devices (MAD) and finally otolaryngology or maxillofacial surgery. Among surgical techniques, central is barbed reposition pharyngoplasty (BRP), used in the field of multilevel surgery.

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Section: Mandibular Advancement Devices (Mad)mentioning

confidence: 99%

Obstructive sleep apnoea/hypopnoea syndrome: relationship with obesity and management in obese patients

Salzano

Maglitto

Bisogno

et al. 2021

Acta Otorhinolaryngol Ital

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“…También puede ser planteada como cirugía exclusiva en contexto de cirugía de adaptación de dispositivos (PAP/DAM), ya que la obstrucción nasal puede impedir el uso adecuado de una interfase o mascarilla nasal en caso de CPAP (debiendo adaptar interfase oronasal, que suele dar mayor IAH residual y peor tolerancia a largo plazo) o también puede dificultar el uso adecuado de un DAM (que obliga a mantener la boca semicerrada durante su uso, incomodando a pacientes respiradores orales) 22 .…”

Section: B11) Cirugía Nasal Y Nasofaríngeaunclassified

Cirugía del sueño: Definición de una especialidad emergente, propuesta de una clasificación anatomofuncional integral e indicaciones

Bachelet¹,

Castillo²,

Zabala³

et al. 2021

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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“…Anatomical features resulting in increased nasal resistance seem to have a negative impact in the treatment with MAD 17 . Hence, studies evaluating the importance of nasal breathing in candidates for MAD found that those who had increased nasal resistance responded less effectively and had less adherence to treatment when compared to patients without nasal changes 62 .…”

Section: Introductionmentioning

confidence: 99%

Mandibular advancement devices in obstructive sleep apnea: an updated review

Manetta¹,

Ettlin²,

Sanz³

et al. 2022

Sleep Sci

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Obstructive sleep apnea (OSA) is the most prevalent sleep-disordered breathing in the adult population and if untreated remains a significant cause of morbidity and mortality. Continuous positive airway pressure (CPAP) therapy is still the gold standard treatment for OSA, but patient acceptance and adherence are often poor due to a multitude of factors, thereby compromising treatment success. Mandibular advancement devices (MADs) have been proposed not only as a first line therapy for symptomatic snoring patients, but also for those suﬀering from mild to moderate OSA, or those who refuse or do not tolerate CPAP. Yet, improved understanding of MAD regarding design, construction, and mechanisms of action is an important requirement to successfully implement MAD as a therapeutic tool. Therefore, the main focus of this paper is to focus on the general concepts and mechanisms of action of MAD, while highlighting important characteristics in the context of their use as a viable and effective treatment option for OSA patients.

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

Abstract: 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.

Cited by 10 publications

References 20 publications

Obstructive sleep apnoea/hypopnoea syndrome: relationship with obesity and management in obese patients

Obstructive sleep apnoea/hypopnoea syndrome: relationship with obesity and management in obese patients

Cirugía del sueño: Definición de una especialidad emergente, propuesta de una clasificación anatomofuncional integral e indicaciones

Mandibular advancement devices in obstructive sleep apnea: an updated review

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