Mechanism of action and therapeutic indication of prosthetic mandibular advancement in obstructive sleep apnea syndrome
- 1 April 1998
- journal article
- Published by Wiley in Psychiatry and Clinical Neurosciences
- Vol. 52 (2), 227-229
- https://doi.org/10.1111/j.1440-1819.1998.tb01045.x
Abstract
Prosthetic mandibular advancement (PMA) was applied to nine patients with obstructive sleep apnea syndrome (OSAS) and its therapeutic usefulness, mechanism of action, and clinical indication were discussed based on polysomnographic findings and serial examination of upper airway before and during PMA treatment. Apnea hypopnea index significantly decreased during PMA treatment compared with the value before treatment (P < 0.01) and the rate of the treatment responder counted 78.1%. Cephalometric variables indicated forward and inferior advancement of mandible in our subjects. Magnetic resonance imaging of the upper airway during sleep revealed a marked improvement of velophanryngeal obstruction in most subjects. In addition, intraesophageal negative pressure during sleep decreased significantly. Our results confirmed the high therapeutic efficacy of PMA for OSAS and indicated forward advancement of the mandible and decrease of negative pressure loading on upper airway with PMA might suppress velopharyngeal collapse. Thus, PMA was regarded as one of the treatments of choice for OSAS occurring based on with velopharyngeal narrowing.Keywords
This publication has 7 references indexed in Scilit:
- A Crossover Study Comparing the Efficacy of Continuous Positive Airway Pressure With Anterior Mandibular Positioning Devices on Patients With Obstructive Sleep ApneaChest, 1996
- Pathophysiology of obstructive sleep apnoeaEuropean Respiratory Journal, 1995
- Efficacy of a Herbst mandibular advancement device in obstructive sleep apnea.American Journal of Respiratory and Critical Care Medicine, 1994
- Predictive Value of Muller Maneuver, Cephalometry and Clinical Features for the Outcome of Uvulopalatopharyngoplasty Evaluation of Predictive Factors using Discriminant Analysis in 30 Sleep Apnea PatientsActa Oto-Laryngologica, 1994
- Pharyngeal Narrowing and Closing Pressures in Patients with Obstructive Sleep ApneaAmerican Review of Respiratory Disease, 1993
- Effect of Anterior Mandibular Positioning on Obstructive Sleep ApneaAmerican Review of Respiratory Disease, 1993
- Treatment of Sleep Apnea by Prosthetic Mandibular AdvancementPublished by Springer Science and Business Media LLC ,1987