PT - JOURNAL ARTICLE AU - S. Tsuiki AU - A.A. Lowe AU - F.R. Almeida AU - N. Kawahata AU - J.A. Fleetham TI - Effects of mandibular advancement on airway curvature and obstructive sleep apnoea severity AID - 10.1183/09031936.04.00094304 DP - 2004 Feb 01 TA - European Respiratory Journal PG - 263--268 VI - 23 IP - 2 4099 - http://erj.ersjournals.com/content/23/2/263.short 4100 - http://erj.ersjournals.com/content/23/2/263.full SO - Eur Respir J2004 Feb 01; 23 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.