A new tongue advancement technique for sleep-disordered breathing: side effects and efficacy.

Abstract

We examined the efficacy and the acceptance of an oral device (SnorEx) causing a forward displacement of the tongue for the treatment of sleep-disordered breathing (SDB). Twenty-three consecutive subjects with SDB were investigated. Noncompliance (NC) of use of the oral appliance was observed in 74% (17 of 23) of the subjects. NC patients were characterized by unacceptable local side effects of the prosthesis, lacking improvement of indicators of daytime well-being, and a missing reduction of the respiratory disturbance index (RDI). The device was tolerated without side effects in 26% (6 of 23) of the subjects. In these compliant (C) subjects the RDI, EDS, and snoring improved significantly (p < 0.05) compared with baseline values. After 6 mo using the device, five of the six C patients were still using it. We conclude that the high rate of noncompliance and the low efficacy of the SnorEx prosthesis preclude large-scale use of this treatment modality in patients with SDB and snoring since the local side effects are the principal cause of NC. No useful predictive parameter of treatment compliance or treatment success was found. Thus, this dental appliance should be prescribed only for selected patients failing other treatment modalities seen by an experienced sleep-disorders specialist.

MRI of the pharynx and treatment efficacy of a mandibular advancement device in obstructive sleep apnoea syndrome

“…Unfortunately, treatment success is only y50% [14], a percentage that was also realised with the device used in this study. At present, both the reason for this low success rate and useful predictive parameters of treatment success are not known [15]. It can be speculated that some specific anatomical configuration can be used to predict success or failure of the device [16].…”

Gibt es Alternativen zum nCPAP-Verfahren in der Behandlung des obstruktiven Schlafapnoesyndroms?

“…In einer Studie mit 23 Patienten brachen 17 die Behandlung we− gen Unverträglichkeit ab, von den verbleibenden Patienten hat− ten n = 3 einen AHI < 10/h und n = 3 einen AHI > 10/h [63]. Akzep− tanz und Wirksamkeit dieses Verfahrens sind nicht hinreichend (Empfehlungsgrad D).…”

Therapie der obstruktiven Schlafapnoe mit intraoralen Schnarch-Therapie-(IST-) Geräten

“…Zu diesem Ger~it existieren nur zwei Studien [18,22]. In emer Untersuchung an 23 Patienten tolerierten 9 (39%) das ,,SnorEx"-Ger~it aufgrund von lokalen Nebenwirkungen tiberhaupt nicht [18].…”

“…In emer Untersuchung an 23 Patienten tolerierten 9 (39%) das ,,SnorEx"-Ger~it aufgrund von lokalen Nebenwirkungen tiberhaupt nicht [18]. im Vordergrund standen Speichelflul3, Wtirgereiz und trockene Schleimh~iute.…”