Clark G T, Arand D, Chung E, Tong D
Dental Research Institute, School of Dentistry, University of California, Los Angeles 90024-1668.
Am Rev Respir Dis. 1993 Mar;147(3):624-9. doi: 10.1164/ajrccm/147.3.624.
This prospective case report series utilized an anterior mandibular positioning (AMP) device on obstructive sleep apnea (OSA) patients and evaluated the changes in the respiratory disturbance index (RDI) and subjective overall satisfaction with the treatment. The RDI was based on all-night polysomnographic studies performed before and after approximately 4 months of appliance use. Overall satisfaction with the treatment was rated using a Likert scale (0 to 10) after 6, 18, and 36 months of AMP device use. Although only 15 of the 24 subjects agreed to undergo post-appliance polysomnograms, 14 of the 15 subjects showed a clear decrease in the RDI. The effect on the other subjects is unknown, but even if the 9 subjects without polysomnograms had no change in the RDI from the AMP device, a minimum rate of 58% of the subjects (14 of 24) would have substantially improved the RDI at the 3-month time point. Of the 24 subjects, 2 subjects claimed no immediate benefit and stopped using the device, 4 subjects were lost to followup, 1 subject lost weight and stopped using the device, 1 subject had mandibular advancement surgery after using the appliance for a period of time, and 3 stopped using the appliance because of persistent temporomandibular pain problems. The remaining 12 of the 23 (52%) original subjects were still using the appliance successfully at 36 months. One subject died of non-apnea-related causes before the 18-month follow-up time point. The 16 subjects who responded at 36 months reported a mean overall satisfaction with treatment of 6.9 +/- 3.3 on a scale of 10.
本前瞻性病例报告系列研究对阻塞性睡眠呼吸暂停（OSA）患者使用了下颌前位定位（AMP）装置，并评估了呼吸紊乱指数（RDI）的变化以及患者对治疗的主观总体满意度。RDI基于在使用该矫治器约4个月前后进行的整夜多导睡眠图研究。在使用AMP装置6个月、18个月和36个月后，使用李克特量表（0至10）对治疗的总体满意度进行评分。尽管24名受试者中只有15名同意在使用矫治器后接受多导睡眠图检查，但这15名受试者中有14名的RDI明显下降。对其他受试者的影响尚不清楚，但即使9名未进行多导睡眠图检查的受试者的RDI未因AMP装置而改变，在3个月时间点，至少58%的受试者（24名中的14名）的RDI会有显著改善。24名受试者中，2名声称未立即受益并停止使用该装置，4名受试者失访，1名受试者体重减轻并停止使用该装置，1名受试者在使用该矫治器一段时间后接受了下颌前移手术，3名受试者因持续性颞下颌关节疼痛问题而停止使用该矫治器。在最初的23名受试者中，其余12名（52%）在36个月时仍在成功使用该矫治器。1名受试者在18个月随访时间点前死于与呼吸暂停无关的原因。在36个月时做出回应的16名受试者报告，治疗的总体满意度平均为6.9±3.3（满分10分）。
