Kuna Samuel T, Giarraputo Philip C, Stanton David C, Levin Lawrence M, Frantz Don
Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 May;101(5):593-603. doi: 10.1016/j.tripleo.2005.08.033. Epub 2006 Feb 21.
To determine whether a manually adjustable oral mandibular advancement titration appliance (EMA-T) predicts successful long-term treatment with an oral mandibular advancement appliance (MAA).
At an academic medical center, 21 adults with obstructive sleep apnea (AHI > 10 events/hr) performed baseline, titration, and MAA (Klearway) polysomnograms. During the titration polysomnogram with EMA-T, the mandible was advanced until apneas and hypopneas were eliminated or maximum tolerable advancement was reached. Participants then used the MAA at home and, once the mandible was advanced to the amount determined during the titration polysomnogram, a polysomnogram with MAA was performed.
Mean AHI at baseline was 33.5 +/- 18.3 (SD) events/hr. During the titration polysomnogram, 9 subjects achieved an AHI < 10 and at least a 50% reduction in AHI. None of the subjects met these criteria on the MAA polysomnogram.
EMA-T lowered the AHI to efficacious levels in 43% of patients but this acute response did not predict the efficacy of long-term MAA treatment.
确定手动可调式口腔下颌前移滴定装置（EMA-T）是否能预测口腔下颌前移装置（MAA）长期治疗的成功。
在一家学术医疗中心，21名患有阻塞性睡眠呼吸暂停（呼吸暂停低通气指数>10次/小时）的成年人进行了基线、滴定和MAA（Klearway）多导睡眠图检查。在使用EMA-T进行滴定多导睡眠图检查期间，下颌向前推进，直到呼吸暂停和呼吸浅慢消失或达到最大可耐受推进量。参与者随后在家中使用MAA，一旦下颌推进到滴定多导睡眠图检查期间确定的量，就进行一次MAA多导睡眠图检查。
基线时平均呼吸暂停低通气指数为33.5±18.3（标准差）次/小时。在滴定多导睡眠图检查期间，9名受试者的呼吸暂停低通气指数<10，且呼吸暂停低通气指数至少降低了50%。在MAA多导睡眠图检查中，没有受试者达到这些标准。
EMA-T使43%的患者呼吸暂停低通气指数降至有效水平，但这种急性反应并不能预测长期MAA治疗的疗效。
