Mahl N, Schuff S, Mattheis S, Siegert R
Prosper-Hospital Recklinghausen, Klinik für HNO-Heilkunde, Kopf- und Hals-Chirurgie, Recklinghausen.
Laryngorhinootologie. 2007 Jun;86(6):421-5. doi: 10.1055/s-2007-966322. Epub 2007 Apr 26.
Besides operation the mandibular advancement splint (MAS) is one of the main options for treatment of snoring. Especially the MAS by Hinz, which exclusively blocks mandibular retrusion, has been established as an effective alternative. The aim of this study is to examine the effectiveness of this MAS and to evaluate the role of obstruction at the level of the tongue base as a successful pretherapeutic predictor by using the sleep nasal endoscopy.
From August 2001 until August 2006 we have examined over 450 patients with sleep disorders at our hospital. All patients have had an ENT examination, a standardized polysomnography and a sleep nasal endoscopy with therapy simulation. The application of a MAS is indicated if an obstruction at the level of the tongue base is detected and the RDI (respiratory disturbance index) is below 10/h. 10 patients are examined by PSG and partly by sleep nasal endoscopy before and after adjustment of the MAS. The patient group is classified in three velum- (n = 3), isolated tongue base-snorers, five combined tongue base-/velum- and two tongue base-/epiglottis-snorers.
The subjective sleep recovery and the snoring-intensity can be improved by the MAS in eight of ten patients. In addition the long-term acceptance of this therapy is very high.
According to our experiences the MAS by Hinz is an effective treatment option for patients with an obstruction level at the tongue base confirmed by sleep nasal endoscopy.
除手术外，下颌前移矫治器（MAS）是治疗打鼾的主要选择之一。特别是欣茨设计的MAS，它专门用于阻止下颌后缩，已被确立为一种有效的替代方法。本研究的目的是通过睡眠鼻内镜检查来检验这种MAS的有效性，并评估舌根水平阻塞作为治疗前成功预测指标的作用。
从2001年8月至2006年8月，我们在我院对450多名睡眠障碍患者进行了检查。所有患者均接受了耳鼻喉科检查、标准化多导睡眠图检查以及带有治疗模拟的睡眠鼻内镜检查。如果检测到舌根水平阻塞且呼吸紊乱指数（RDI）低于10次/小时，则表明需要应用MAS。在调整MAS前后，对10名患者进行了多导睡眠图检查，部分患者还进行了睡眠鼻内镜检查。患者组分为三组：软腭型（n = 3）、单纯舌根型打鼾者、五名舌根/软腭混合型以及两名舌根/会厌混合型打鼾者。
10名患者中有8名患者的主观睡眠恢复情况和打鼾强度通过MAS得到了改善。此外，这种治疗方法的长期接受度非常高。
根据我们的经验，欣茨设计的MAS对于经睡眠鼻内镜检查证实为舌根水平阻塞的患者是一种有效的治疗选择。
