Maxillofacial Surgery Unit, Faculty of Medicine, University Hospital 'A. Gemelli', Catholic University of the Sacred Heart, IRCCS, 00168 Rome, Italy.
Dipartimento di Neuroscienze, Sezione di Fisica, University Hospital 'A. Gemelli', Catholic University of the Sacred Heart, IRCCS, 00168 Rome, Italy.
Int J Environ Res Public Health. 2021 Mar 1;18(5):2393. doi: 10.3390/ijerph18052393.
The use of a mandibular advancement device (MAD) in the treatment of obstructive sleep apnea (OSA) is a consolidated therapy. This study aimed to evaluate the predictive value of awake upper airways (UA) functional endoscopy in identifying the outcome of MAD therapy.
This observational prospective study included 30 adult OSA patients, all patients underwent pre-treatment awake UA functional endoscopy, during the exam subjects were instructed to advance their mandible maximally, and they were divided into three different groups according to the response of the soft tissue, group A (expansion), group B (stretch), group C (unchanged). The results of this test were used in combination with other noninvasive indexes to predict the treatment outcome in terms of apnea-hypopnea index (AHI) reduction.
We found that a substantial AHI reduction occurred in group A and group B while e slight AHI reduction was measured in group C.
Based on our experience the awake UA endoscopy is a valid prognostic exam for discriminating responder and non-responder patients; in addition our results indicate the possibility of predicting a range of post-treatment AHI index values.
下颌前伸装置（MAD）在阻塞性睡眠呼吸暂停（OSA）治疗中的应用是一种已确立的疗法。本研究旨在评估清醒时上气道（UA）功能内镜在识别 MAD 治疗效果中的预测价值。
这是一项前瞻性观察研究，纳入了 30 例成年 OSA 患者。所有患者均在治疗前进行清醒时 UA 功能内镜检查，检查过程中指导患者最大限度地下颌前伸，并根据软组织的反应将患者分为三组：A 组（扩张）、B 组（伸展）和 C 组（无变化）。该测试的结果与其他非侵入性指标结合使用，以预测在呼吸暂停低通气指数（AHI）降低方面的治疗效果。
我们发现 A 组和 B 组的 AHI 显著降低，而 C 组的 AHI 仅轻度降低。
根据我们的经验，清醒时 UA 内镜检查是一种有效的预后检查方法，可区分应答者和无应答者患者；此外，我们的结果表明有可能预测治疗后 AHI 指数值的范围。
