药物诱导睡眠内镜检查和同时进行多导睡眠图监测以预测下颌前伸装置治疗阻塞性睡眠呼吸暂停的效果。
Drug induced sleep endoscopy and simultaneous polysomnography to predict the effectiveness of mandibular advancement device in obstructive sleep apnea treatment.
作者信息
Piccin Ottavio, Pelligra Irene, Bonetti Giulio Alessandri, Bonsembiante Anna
机构信息
Centre for Medical Sciences, University of Trento, Trento, Italy.
Division of Otolaryngology Head and Neck Surgery, S.Chiara Hospital, Trento, Italy.
出版信息
Eur Arch Otorhinolaryngol. 2024 Dec;281(12):6693-6698. doi: 10.1007/s00405-024-09017-w. Epub 2024 Oct 23.
PURPOSES
To evaluate whether mandibular advancement device therapy is recommended in patients affected by obstructive sleep apnea.
METHODS
In order to predict oral appliances therapy response, drug induced sleep endoscopy with cardio-respiratory polygraphy and mandibular advancement device simulator was carried out. Patients in which upper airway obstruction was resolved on all levels and AHI was normalized (< 5/h), were referred for oral appliance therapy. At 5 months follow up, a cardio-respiratory polygraphy with MAD was performed.
RESULTS
36 patients who have evidence of resolution of UA collapse and AHI below 5 events per hour, were referred for MAD therapy. At follow up, the mean AHI decreased from 29.1 ± 13.1 to 3.3/h ± 1.9 (p < 0.001). All the patients were responders.
CONCLUSION
Combining the evaluation of drug induced sleep endoscopy and cardio-respiratory polygraphy data simultaneously during mandibular protrusion, has the potential to be a useful tool for prediction of MAD therapy response.
目的
评估下颌前伸装置治疗是否适用于阻塞性睡眠呼吸暂停患者。
方法
为了预测口腔矫治器治疗的反应，进行了药物诱导睡眠内镜检查，并结合心肺多导图和下颌前伸装置模拟器。在上气道在所有水平上的阻塞均得到解决，且 AHI 正常化（<5/小时）的患者，被推荐接受口腔矫治器治疗。在 5 个月的随访中，进行了带有 MAD 的心肺多导图检查。
结果
36 名患者上气道塌陷得到缓解且 AHI 低于 5 次/小时，被推荐接受 MAD 治疗。在随访时，平均 AHI 从 29.1±13.1 降至 3.3/h±1.9（p<0.001）。所有患者均为应答者。
结论
在进行下颌前伸时，同时评估药物诱导睡眠内镜检查和心肺多导图数据，可能成为预测 MAD 治疗反应的有用工具。
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