Guarda-Nardini Luca, Manfredini Daniele, Mion Marta, Heir Gary, Marchese-Ragona Rosario
Department of Maxillofacial Surgery, TMD Clinic, University of Padova, Padova, Italy.
Institute of Otolaryngology, Department of Neurosciences, Padova University, Padova, Italy.
J Clin Sleep Med. 2015 Nov 15;11(11):1327-34. doi: 10.5664/jcsm.5198.
The aim of this review is to summarize data from the literature on the predictive value of anatomy-based parameters, as identified by cephalometry, for the efficacy of mandibular advancement devices (MAD) for the treatment of obstructive sleep apnea (OSA).
Articles were initially selected based on their titles or abstracts. Full articles were then retrieved and further scrutinized according to predetermined criteria. Reference lists of selected articles were searched for any missed publications. The selected articles were methodologically evaluated.
Of an initial 311 references, 13 were selected that assessed correlations between polysomnographic and cephalometric variables. The majority of studies demonstrated a correlation between treatment effectiveness and features as determined by cephalometric analysis, such as the mandibular plane angle, hyoid bone distance to mandible, antero-posterior diameter of the maxilla, tongue area, cranial base, and soft palate.
The mandibular plane angle and the distance between hyoid bone and mandibular plane was found to have a predictive value for MAD effectiveness in OSA patients. However, the relative weak and somewhat inconsistent cephalometric data suggest that decisions based solely on these factors cannot be recommended, especially because an integrated analysis of other risk factors (e.g., age, sex, BMI) should also be taken into account.
本综述旨在总结文献中有关经头影测量确定的基于解剖学参数对下颌前移装置（MAD）治疗阻塞性睡眠呼吸暂停（OSA）疗效的预测价值的数据。
文章最初根据标题或摘要进行筛选。随后检索全文并根据预定标准进行进一步审查。对所选文章的参考文献列表进行搜索，以查找任何遗漏的出版物。对所选文章进行方法学评估。
在最初的311篇参考文献中，选择了13篇评估多导睡眠图和头影测量变量之间相关性的文章。大多数研究表明治疗效果与头影测量分析确定的特征之间存在相关性，如下颌平面角、舌骨到下颌骨的距离、上颌前后径、舌面积、颅底和软腭。
发现下颌平面角以及舌骨与下颌平面之间的距离对OSA患者使用MAD的疗效具有预测价值。然而，头影测量数据相对较弱且有些不一致，这表明不建议仅基于这些因素做出决策，特别是因为还应考虑对其他风险因素（如年龄、性别、BMI）进行综合分析。
