Dose-Dependent Effects of Mandibular Advancement on Pharyngeal Mechanics and Nocturnal Oxygenation in Patients With Sleep-Disordered Breathing

SummaryDespite being a standard procedure during induction of anaesthesia, facemask ventilation can be a major challenge especially for inexperienced anaesthetists. We manufactured a Jaw-Thrust-Device designed to keep the patient's jaws in an optimised position, and thus to maintain the airway in a permanently patent state. Using a cross over design, we compared the influence of using the Esmarch manoeuvre (bimanual jaw-thrust), a nasopharyngeal airway, an oropharyngeal airway, or the Jaw-Thrust-Device on airway physiology in 50 healthy adults with body mass index < 35 kg.m )2 , undergoing standard facemask ventilation for routine induction of anaesthesia.The main study endpoints were expiratory tidal volumes, airway resistances, and gas flow rates. The Jaw-Thrust-Device was more effective in increasing expiratory tidal volumes and peak inspiratory flow than a standard Esmarch manoeuvre, and was more effective than both nasopharyngeal and oropharyngeal airways in decreasing airway resistance.

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“…This device is similar to tooth brackets, and fixes the patient's jaws in an improved Esmarch position intended to avoid glossoptosis [7,8].…”

mentioning

confidence: 99%

Optimising the unprotected airway with a prototype Jaw‐Thrust‐Device – a prospective randomised cross‐over study

Goedecke

Mitterschiffthaler

Paal³

et al. 2009

Anaesthesia

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“…Regarding the efficacy of intra-oral devices, several authors state in their studies [16][17][18][19] that they represent a good alternative for treating snoring and OSAH, due to a reduced cost and their relatively comfortable use, being more accepted by patients. Although there are conflicting doubts on the efficacy of intra-oral devices for treating snoring and OSAH, its use in the treatment of medium severity apnea has received great attention and acceptability.…”

Section: Discussionmentioning

confidence: 99%

Tratamento da síndrome da apnéia e hipopnéia obstrutiva do sono com aparelhos intrabucais

Almeida¹,

Teixeira

Vieira

et al. 2006

Rev. Bras. Otorrinolaringol.

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Obst ructive sleep apnea and hipoapnea syndrome (OSAHS) is a disorder that affects about 4% of the adult population, and besides the social problems associated to snoring and extreme day time sleepiness, it is preoccupying since it may cause pulmonary hypertension and cardiac failure. Review and discussion -Through a literature review, we discuss the use of oral appliances to treat this condition, in regards of therapy effectiveness and limitations, main clinical symptoms, major occlusal side effects, rate of improvement and patient satisfaction. Conclusions -We concluded that the use of oral appliances should be a first choice treatment for mild to moderate OSAHS, being dental, joint and muscular discomforts, hypersalivation and xerostomia, the most frequent clinical symptoms, with light occlusal side effects that normally do not bother the patients, with a good degree of improvement and high satisfaction index.

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“…48 Skuteczność lecznicza aparatów MAD oraz lepsza ich akceptacja w grupie badanych ma często związek z konstrukcją szyn i parametrami według których szyny pozostają względem siebie. 36,[49][50][51] Stwierdzono, że jednoczęściowe aparaty są lepiej tolerowane przez pacjentów w porównaniu z aparatami dwuczęściowymi ze względu na łatwiejsze zakładanie i zdejmowanie oraz utrzymanie wła-ściwej higieny. 49 Bloch i wsp.…”

Section: T H I S C O P Y I S F O R P E R S O N a L U S E O N L Y -D Iunclassified

“…przedstawili pogląd, że na każde 2 mm wysunięcia żuchwy przypada wzrost skuteczności terapeutycznej aparatu o ok. 20%. 51 Ustalenie żuchwy w położeniu 70% maksymalnej protruzji stanowi kompromis pomiędzy skutecznością aparatu, a potencjalnie mogącymi wystąpić efektami ubocznymi ich stosowania. 33 W odniesieniu do pionowego wymiaru zgryzu konstrukcyjnego uważa się, że powinien on pozostać na minimalnym poziomie, ze wzglę-du na to, iż zwiększenie wymiaru pionowego poprzez odwiedzenie żuchwy doprowadza do przemieszczenia języka w dół i ku tyło-wi, zmniejszając tym samym drożność drogi oddechowej.…”

Section: T H I S C O P Y I S F O R P E R S O N a L U S E O N L Y -D Iunclassified

Obstructive sleep apnea: Aetiology, diagnosis, treatment

Wojda¹,

Kostrzewa-Janicka²

2015

Protet Stomatol

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Dose-Dependent Effects of Mandibular Advancement on Pharyngeal Mechanics and Nocturnal Oxygenation in Patients With Sleep-Disordered Breathing

Cited by 232 publications

References 16 publications

Optimising the unprotected airway with a prototype Jaw‐Thrust‐Device – a prospective randomised cross‐over study

Optimising the unprotected airway with a prototype Jaw‐Thrust‐Device – a prospective randomised cross‐over study

Tratamento da síndrome da apnéia e hipopnéia obstrutiva do sono com aparelhos intrabucais

Obstructive sleep apnea: Aetiology, diagnosis, treatment

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