RT Journal Article
SR Electronic
T1 Effects of mandibular advancement on airway curvature and obstructive sleep apnoea severity
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 263
OP 268
DO 10.1183/09031936.04.00094304
VO 23
IS 2
A1 S. Tsuiki
A1 A.A. Lowe
A1 F.R. Almeida
A1 N. Kawahata
A1 J.A. Fleetham
YR 2004
UL http://erj.ersjournals.com/content/23/2/263.abstract
AB In a curved tube, the amount of airflow appears to be influenced by the amount of curvature. The purpose of this study was to investigate changes in obstructive sleep apnoea (OSA) severity and awake velopharyngeal curvature in response to an anteriorly titrated mandibular position in 20 male OSA patients. Baseline supine cephalometry was obtained before the initial insertion of a titratable oral appliance and follow-up supine cephalometry was undertaken after titration of the mandibular position with the appliance in place. The mean apnoea/hypopnea index (AHI) before treatment (31.6±13.0 events·h−1) was significantly reduced (9.8±7.4 events·h−1) after titration of the mandibular position in all 20 patients. There was a significant increase in the anteroposterior calibre and the radius of the curvature of the anterior wall of the velopharynx in 14 good responders who exhibited an AHI reduction to ≤15. Similar observations were not found in six poor responders. To conclude, an anteriorly titrated mandibular position reduced obstructive sleep apnoea severity, enlarged the velopharynx and diminished the curvature of the anterior velopharyngeal wall in good responders. It is proposed that this change in the upper airway curvature associated with mandibular advancement may effect obstructive sleep apnoea severity through its effect on airflow dynamics. Part of this study was supported by Grants-in-Aid for Scientific Research Projects (15659469) from the Japanese Ministry of Education, Culture. F.R. Almeida was supported by a scholarship from CNP9-Brazil, Brazil.