Different therapeutic mechanisms of rigid and semi-rigid mandibular repositioning devices in obstructive sleep apnea syndrome
Different therapeutic mechanisms of rigid and semi-rigid mandibular repositioning devices in obstructive sleep apnea syndrome
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DOI：
10.1016/j.jcms.2014.05.007
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发表时间：
2014-12-01
影响因子：
3.1
通讯作者：
Ueyama, Yoshiya
中科院分区：
文献类型：
--
作者：
Suga, Hokuto;Mishima, Katsuaki;Ueyama, Yoshiya
为阐明硬性和半硬性下颌骨复位器在阻塞性睡眠呼吸暂停综合征(OSAS)中的作用机制，分别对7例和13例患者进行了硬性和半硬性下颌骨复位器(MRD)治疗。每个患者在最初的会诊和症状改善后都进行了多导睡眠图和计算机断层扫描检查。用图像处理软件(MIMICS Version 14.2)重建上呼吸道(硬腭水平至会厌根部)的三维模型，测量气道形态。硬性MRD组的平均年龄为58.1岁，体重指数为24.8 kg/m(2)，半刚性MRD组的平均年龄为57.9岁，体质量指数为23.2 kg/m(2)。呼吸暂停低通气指数显著改善(P<；0.05，Wilcoxon符号等级检验)，从每小时睡眠22.0次增加到8.9次，从20.5次增加到11.5次。会厌尖部(2.0~2.6 cm(2))和硬腭部(2.6~3.3 cm(2))的横截面积在各组中也有所增加(P<；0.05)。然而，在悬垂尖端水平测量的气道容量、横截面积以及气道的前后径和横径没有显著差异。总而言之，这两种类型的MRD都可以改善呼吸状况，但它们影响的是呼吸道的不同部分。(C)2014年欧洲颅颌面部外科协会。爱思唯尔有限公司出版。保留所有权利。
To clarify the mechanisms of rigid and semi-rigid mandibular repositioning devices (MRDs) in obstructive sleep apnea syndrome (OSAS), seven and 13 patients received rigid and semi-rigid MRDs, respectively. Each patient underwent polysomnographic and computed tomographic examinations at the initial consultation and after symptom improvement. Three-dimensional models of the upper airway (hard palate level to epiglottic base) were reconstructed by image processing software (Mimics version 14.2) to measure airway morphology. The mean age and body mass index were 58.1 years and 24.8 kg/m(2), respectively, in the rigid MRD group and 57.9 years and 23.2 kg/m(2), respectively, in the semi-rigid MRD group. The apnea-hypopnea index significantly improved (P < 0.05, Wilcoxon signed-rank test) from 22.0 to 8.9 and 20.5 to 11.5 events per hour of sleep in the respective groups. The cross-sectional areas measured at the epiglottic tip (from 2.0 to 2.6 cm(2)) and hard palate (from 2.6 to 3.3 cm(2)) levels also increased in the respective groups (P < 0.05). However, airway volume, cross-sectional area measured at the uvular tip level, and anteroposterior and transverse diameters of the airway were not significantly different. In conclusion, both types of MRDs improve respiratory status, but they affect different parts of the airway. (C) 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.