EFFECT OF ANTERIOR MANDIBULAR POSITIONING ON OBSTRUCTIVE SLEEP-APNEA
EFFECT OF ANTERIOR MANDIBULAR POSITIONING ON OBSTRUCTIVE SLEEP-APNEA
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DOI：
10.1164/ajrccm/147.3.624
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发表时间：
1993-03-01
期刊：
影响因子：
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通讯作者：
TONG, D
中科院分区：
文献类型：
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作者：
CLARK, GT;ARAND, D;TONG, D
该前瞻性病例报告系列使用了阻塞性睡眠呼吸暂停（OSA）患者的下颌前定位（AMP）装置，并评价了呼吸紊乱指数（RDI）和治疗的主观总体满意度的变化。RDI是基于在使用矫治器大约4个月前后进行的整夜多导睡眠图研究。在AMP器械使用6、18和36个月后，使用Likert量表（0 - 10）评定治疗的总体满意度。虽然24名受试者中只有15名同意接受矫治器后多导睡眠图，但15名受试者中有14名显示RDI明显下降。对其他受试者的影响尚不清楚，但即使9例无多导睡眠图的受试者的RDI与AMP器械相比没有变化，至少58%的受试者（24例中的14例）在3个月时间点的RDI会有实质性改善。在24名受试者中，2名受试者声称没有立即受益并停止使用该器械，4名受试者失访，1名受试者体重减轻并停止使用该器械，1名受试者在使用该器械一段时间后进行了下颌前移手术，3名受试者因持续性颞下颌疼痛问题而停止使用该器械。23名原始受试者中的其余12名（52%）在36个月时仍成功使用该器械。1例受试者在18个月随访时间点前死于非呼吸暂停相关原因。在36个月时有应答的16例受试者报告，在10分量表上，对治疗的平均总体满意度为6.9 +/- 3.3。
This prospective case report series utilized an anterior mandibular positioning (AMP) device on obstructive sleep apnea (OSA) patients and evaluated the changes in the respiratory disturbance index (RDI) and subjective overall satisfaction with the treatment. The RDI was based on all-night polysomnographic studies performed before and after approximately 4 months of appliance use. Overall satisfaction with the treatment was rated using a Likert scale (0 to 10) after 6, 18, and 36 months of AMP device use. Although only 15 of the 24 subjects agreed to undergo post-appliance polysomnograms, 14 of the 15 subjects showed a clear decrease in the RDI. The effect on the other subjects is unknown, but even if the 9 subjects without polysomnograms had no change in the RDI from the AMP device, a minimum rate of 58% of the subjects (14 of 24) would have substantially improved the RDI at the 3-month time point. Of the 24 subjects, 2 subjects claimed no immediate benefit and stopped using the device, 4 subjects were lost to followup, 1 subject lost weight and stopped using the device, 1 subject had mandibular advancement surgery after using the appliance for a period of time, and 3 stopped using the appliance because of persistent temporomandibular pain problems. The remaining 12 of the 23 (52%) original subjects were still using the appliance successfully at 36 months. One subject died of non-apnea-related causes before the 18-month follow-up time point. The 16 subjects who responded at 36 months reported a mean overall satisfaction with treatment of 6.9 +/- 3.3 on a scale of 10.