Yoshida K
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Kyoto University.
Nervenarzt. 1998 Aug;69(8):666-70. doi: 10.1007/s001150050326.
To clarify the functional mechanism of the Esmarch device in the treatment of sleep apnea, its effect on muscle activity during sleep was studied electromyographically with and without the appliance at the inferior head of the lateral pterygoid muscle, the genioglossal muscle, and the masseter muscle in 15 patients with sleep apnea syndrome. During the obstructive apnea the muscles showed significantly lower amplitudes than before the apnea. No significant decrease in the amplitude was observed during the central apnea, but, after the obstructive and central apnea, significantly higher amplitudes were seen than beforehand. The amplitudes rose after the placement of the appliance, and the amplitudes of the genioglossal and lateral pterygoid muscles during obstructive apnea increased significantly after the insertion of the appliance. The results suggest that the device can activate the masticatory and tongue muscle activity and indicate that the muscles activated with the appliance can prevent obstruction in the oropharynx. The Esmarch device not only helps avoid obstruction by mandibular protraction, but also affects function by activating the muscles.
为阐明埃斯马赫装置治疗睡眠呼吸暂停的功能机制,对15例睡眠呼吸暂停综合征患者,在翼外肌下头、颏舌肌和咬肌处,通过肌电图研究了该装置在佩戴和不佩戴时对睡眠期间肌肉活动的影响。在阻塞性呼吸暂停期间,肌肉振幅显著低于呼吸暂停前。中枢性呼吸暂停期间未观察到振幅显著下降,但在阻塞性和中枢性呼吸暂停后,振幅显著高于之前。佩戴该装置后振幅升高,佩戴后阻塞性呼吸暂停期间颏舌肌和翼外肌的振幅显著增加。结果表明,该装置可激活咀嚼肌和舌肌活动,并表明该装置激活的肌肉可防止口咽阻塞。埃斯马赫装置不仅有助于通过下颌前伸避免阻塞,还通过激活肌肉影响功能。