The tongue-retaining device: efficacy and side effects in obstructive sleep apnea syndrome.
The tongue-retaining device: efficacy and side effects in obstructive sleep apnea syndrome.
复制标题
舌保留装置：阻塞性睡眠呼吸暂停综合征的功效和副作用。
DOI：
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
F. Chabolle
中科院分区：
文献类型：
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作者：
D. Lazard;M. Blumen;P. Lévy;P. Chauvin;D. Fragny;I. Buchet;F. Chabolle
研究目的
舌保持装置是一种定制的整体式口腔矫治器，用于治疗阻塞性睡眠呼吸暂停综合征（OSAS）。本研究评价了OSAS患者对舌保留装置的有效性及其耐受性。
方法
对84例呼吸暂停患者的病历进行回顾性分析，并通过电话联系患者回答口头问卷。中位随访时间为5年。
结果
根据呼吸暂停低通气指数，71%的病例获得完全或部分缓解。平均呼吸暂停低通气指数从38显著降低到14（p < 0.001）。打鼾的主观强度降低了68%（p < 0.0001），埃普沃思嗜睡量表评分从9分降至6分（p < 0.05）。年龄大于60岁且下颌前突距离小于或等于7 mm的患者预测无应答（比值比[OR]：7.25; 95%置信区间[CI]：1.43-36.7; p < 0.02）。5年随访后，通过问卷调查的回答确定的依从率为52%。鼻塞是良好顺应性的负预测因子（OR：6.94; 95% CI：0.28-0.79; p < 0.005），而I类闭塞患者的顺应性高于II类或III类闭塞患者（OR：3.83; 95% CI：1.00-2.81; p < 0.05）。
结论
固舌器械的性能往往与下颌前移器械相似。因此，在舌头保留装置的制造和安装培训的团队可能会建议它作为一种替代持续气道正压通气，考虑鼻塞作为禁忌症。
STUDY OBJECTIVES
The tongue-retaining device is a customized monobloc oral appliance used in the treatment of obstructive sleep apnea syndrome (OSAS). This study evaluated tongue-retaining device efficacy and its tolerance by patients with OSAS.
METHODS
The charts of 84 apneic patients were retrospectively analyzed, and patients were contacted by telephone to answer an oral questionnaire. The median follow-up time was 5 years.
RESULTS
Based on the apnea-hypopnea index, a complete or partial response was obtained in 71% of the cases. The mean apnea-hypopnea index decreased significantly from 38 to 14 (p < 0.001) with the tongue-retaining device. The subjective intensity of snoring decreased by 68% (p < 0.0001) and the Epworth Sleepiness Scale score decreased from 9 to 6 (p < 0.05). An age of more than 60 years associated with a mandibular protrusion distance inferior or equal to 7 mm was predictive of a nonresponse (odds ratio [OR]: 7.25; 95% confidence interval [CI]: 1.43-36.7; p < 0.02). The compliance rate, as determined by answers to the questionnaire, was 52% after 5 years of follow-up. Nasal obstruction was a negative predictor of good compliance (OR: 6.94; 95% CI: 0.28-0.79; p < 0.005), whereas patients with Class I occlusion were more compliant than patients with Class II or III occlusions (OR: 3.83; 95% CI: 1.00-2.81; p < 0.05).
CONCLUSIONS
Tongue-retaining device performance tended to be similar to that of the mandibular advancement device. Thus, teams trained in tongue-retaining device fabrication and fitting may propose it as an alternative to continuous positive airway pressure, taking nasal obstruction into consideration as a contraindication.