PT  - JOURNAL ARTICLE
AU  - Olivier M. Vanderveken
AU  - Wim Vos
AU  - Jan De Backer
AU  - Kristien Wouters
AU  - Wilfried De Backer
AU  - Marijke Dieltjens
AU  - Marc Braem
TI  - The effect of fixed mandibular advancement on regional upper airway geometry in OSA patients
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P1529
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P1529.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P1529.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - RationaleObstructive sleep apnea (OSA) severity correlates with upper airway (UA) morphology. UA collapsibility however does not respond to mandibular advancement (MA) in an homogeneous way. This study investigates the regional effects in the UA of MA in a large population of OSA patients.Methods100pts were consecutively enrolled. At present baseline polysomnography (PSG) data in terms of apnea-hypopnea index (AHI) is available for 86pts. For 81pts functional CT scan analysis (FRI) is performed without and with MA set in 75% of maximal protrusion (MP). UA volume (iVuaw), resistance (iRuaw), minimal area (Amin) and the distance hyoid-spina mentalis (H-SM) are assessed (see figure). Response is defined as an increase in Amin with MA.ResultsBaseline AHI values correlate with iRuaw (R=0.38), Amin (R=-0.29) and the distance H-SM (R=0.24). MA does increase Amin (+1cm2, p=0.005). Responders (resp) have a larger forward+downward motion of the SM as compared to non-responders (nresp). iVuaw change was predominantly found in responders and was located posterior of the uvula (see figure).ConclusionsAmin and iRuaw do correlate with the severity of OSA. MA does improve these parameters. The largest changes in UA geometry were found posterior of the uvula. Next step is to investigate how these regional geometric changes with MA in situ do relate to clinical outcome.This study was funded by IWT.