Mandibular advancement device therapy in patients with epiglottic collapse.
DISE
Endoscopy
Epiglottis
OSA
Obstructive sleep apnea
Oral appliance
Journal
Sleep & breathing = Schlaf & Atmung
ISSN: 1522-1709
Titre abrégé: Sleep Breath
Pays: Germany
ID NLM: 9804161
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
received:
08
07
2021
accepted:
16
11
2021
revised:
03
11
2021
pubmed:
8
1
2022
medline:
18
11
2022
entrez:
7
1
2022
Statut:
ppublish
Résumé
Epiglottic collapse is a specific sleep-endoscopic finding that can prove challenging to treat in patients with obstructive sleep apnea (OSA). Its effect on mandibular advancement devices (MAD) remains largely unknown. Therefore, this study assessed whether or not epiglottic collapse affects treatment outcome with MAD. Patients with diagnosed OSAD underwent drug-induced sleep endoscopy (DISE) and were treated with a titratable MAD. Two age- and gender-matched controls were selected for every subject with primary epiglottic collapse (i.e., complete closure without involvement of other upper airway structures). Treatment response was defined as a reduction in oxygen desaturation index (ODI) of ≥ 50% following MAD therapy. Of 101 patients who underwent DISE, twenty (20%) showed primary epiglottic collapse (mean [SD]: 17 men; age 49.8 [10.1]; body mass index 28.3 [2.9] kg/m The presence of epiglottic collapse during DISE does not impair the effectiveness of MAD. Therefore, MAD therapy should be considered in patients with predominant epiglottic collapse.
Identifiants
pubmed: 34993758
doi: 10.1007/s11325-021-02532-8
pii: 10.1007/s11325-021-02532-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1915-1920Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Références
Ramar K, Dort LC, Katz SG, Lettieri CJ, Harrod CG, Thomas SM et al (2015) Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy: an update for 2015. J Clin Sleep Med 11(7):773–827
doi: 10.5664/jcsm.4858
pubmed: 26094920
pmcid: 4481062
Phillips CL, Grunstein RR, Darendeliler MA, Mihailidou AS, Srinivasan VK, Yee BJ et al (2013) Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med 187(8):879–887
doi: 10.1164/rccm.201212-2223OC
pubmed: 23413266
Vanderveken OM, Devolder A, Marklund M, Boudewyns AN, Braem MJ, Okkerse W et al (2008) Comparison of a custom-made and a thermoplastic oral appliance for the treatment of mild sleep apnea. Am J Respir Crit Care Med 178(2):197–202
doi: 10.1164/rccm.200701-114OC
pubmed: 17673699
Dieltjens M, Vanderveken OM, Hamans E, Verbraecken JA, Wouters K, Willemen M et al (2013) Treatment of obstructive sleep apnea using a custom-made titratable duobloc oral appliance: a prospective clinical study. Sleep Breath 17(2):565–572
doi: 10.1007/s11325-012-0721-3
pubmed: 22581485
Bratton DJ, Gaisl T, Wons AM, Kohler M (2015) CPAP vs mandibular advancement devices and blood pressure in patients with obstructive sleep apnea: a systematic review and meta-analysis. JAMA 314(21):2280–2293
doi: 10.1001/jama.2015.16303
pubmed: 26624827
Bratton DJ, Gaisl T, Schlatzer C, Kohler M (2015) Comparison of the effects of continuous positive airway pressure and mandibular advancement devices on sleepiness in patients with obstructive sleep apnoea: a network meta-analysis. Lancet Respir Med 3(11):869–878
doi: 10.1016/S2213-2600(15)00416-6
pubmed: 26497082
Schwartz M, Acosta L, Hung YL, Padilla M, Enciso R (2018) Effects of CPAP and mandibular advancement device treatment in obstructive sleep apnea patients: a systematic review and meta-analysis. Sleep Breath 22(3):555–568
doi: 10.1007/s11325-017-1590-6
pubmed: 29129030
Sutherland K, Vanderveken OM, Tsuda H, Marklund M, Gagnadoux F, Kushida CA et al (2014) Oral appliance treatment for obstructive sleep apnea: an update. J Clin Sleep Med 10(2):215–227
doi: 10.5664/jcsm.3460
pubmed: 24533007
pmcid: 3899326
Chan AS, Sutherland K, Schwab RJ, Zeng B, Petocz P, Lee RW et al (2010) The effect of mandibular advancement on upper airway structure in obstructive sleep apnoea. Thorax 65(8):726–732
doi: 10.1136/thx.2009.131094
pubmed: 20685749
Edwards BA, Andara C, Landry S, Sands SA, Joosten SA, Owens RL et al (2016) Upper-airway collapsibility and loop gain predict the response to oral appliance therapy in patients with obstructive sleep apnea. Am J Respir Crit Care Med 194(11):1413–1422
doi: 10.1164/rccm.201601-0099OC
pubmed: 27181367
pmcid: 5148143
Op de Beeck S, Dieltjens M, Verbruggen AE, Vroegop AV, Wouters K, Hamans E, et al. Phenotypic labelling using drug-induced sleep endoscopy improves patient selection for mandibular advancement device outcome: a prospective study. J Clin Sleep Med. 2019;15(8):1089–99.
Marques M, Genta PR, Azarbarzin A, Taranto-Montemurro L, Messineo L, Hess LB et al (2019) Structure and severity of pharyngeal obstruction determine oral appliance efficacy in sleep apnoea. J Physiol 597(22):5399–5410
doi: 10.1113/JP278164
pubmed: 31503323
Ravesloot MJ, de Vries N (2011) One hundred consecutive patients undergoing drug-induced sleep endoscopy: results and evaluation. Laryngoscope 121(12):2710–2716
doi: 10.1002/lary.22369
pubmed: 22109770
Lan MC, Liu SY, Lan MY, Modi R, Capasso R (2015) Lateral pharyngeal wall collapse associated with hypoxemia in obstructive sleep apnea. Laryngoscope 125(10):2408–2412
doi: 10.1002/lary.25126
pubmed: 25582498
Andersen AP, Alving J, Lildholdt T, Wulff CH. Obstructive sleep apnea initiated by a lax epiglottis. A contraindication for continuous positive airway pressure. Chest. 1987;91(4):621–3.
Verse T, Pirsig W (1999) Age-related changes in the epiglottis causing failure of nasal continuous positive airway pressure therapy. J Laryngol Otol 113(11):1022–1025
doi: 10.1017/S0022215100145888
pubmed: 10696386
Vroegop AV, Vanderveken OM, Wouters K, Hamans E, Dieltjens M, Michels NR et al (2013) Observer variation in drug-induced sleep endoscopy: experienced versus nonexperienced ear, nose, and throat surgeons. Sleep 36(6):947–953
doi: 10.5665/sleep.2732
pubmed: 23729939
pmcid: 3649836
Azarbarzin A, Marques M, Sands SA, Op de Beeck S, Genta PR, Taranto-Montemurro L, et al. Predicting epiglottic collapse in patients with obstructive sleep apnoea. Eur Respir J. 2017;50(3).
Marques M, Genta PR, Sands SA, Azarbazin A, de Melo C, Taranto-Montemurro L, et al. Effect of sleeping position on upper airway patency in obstructive sleep apnea is determined by the pharyngeal structure causing collapse. Sleep. 2017;40(3).
Safiruddin F, Koutsourelakis I, de Vries N (2014) Analysis of the influence of head rotation during drug-induced sleep endoscopy in obstructive sleep apnea. Laryngoscope 124(9):2195–2199
doi: 10.1002/lary.24598
pubmed: 24431007
Arora A, Chaidas K, Garas G, Amlani A, Darzi A, Kotecha B et al (2016) Outcome of TORS to tongue base and epiglottis in patients with OSA intolerant of conventional treatment. Sleep Breath 20(2):739–747
doi: 10.1007/s11325-015-1293-9
pubmed: 26669877
Kent DT, Rogers R, Soose RJ (2015) Drug-induced sedation endoscopy in the evaluation of OSA patients with incomplete oral appliance therapy response. Otolaryngol Head Neck Surg 153(2):302–307
doi: 10.1177/0194599815586978
pubmed: 26044788
Op de Beeck S, Van de Perck E, Vena D, Kazemeini E, Dieltjens M, Willemen M, et al. Flow identified site of collapse during drug-induced sleep endoscopy: feasibility and preliminary results. Chest. 2020.
Vena D, Azarbarzin A, Marques M, Op de Beeck S, Vanderveken OM, Edwards BA, et al. Predicting sleep apnea responses to oral appliance therapy using polysomnographic airflow. Sleep. 2020.
Battagel JM, Johal A, L’Estrange PR, Croft CB, Kotecha B (1999) Changes in airway and hyoid position in response to mandibular protrusion in subjects with obstructive sleep apnoea (OSA). Eur J Orthod 21(4):363–376
doi: 10.1093/ejo/21.4.363
pubmed: 10502899
Brown EC, Cheng S, McKenzie DK, Butler JE, Gandevia SC, Bilston LE (2013) Tongue and lateral upper airway movement with mandibular advancement. Sleep 36(3):397–404
doi: 10.5665/sleep.2458
pubmed: 23450677
pmcid: 3571744
Kwon OE, Jung SY, Al-Dilaijan K, Min JY, Lee KH, Kim SW (2019) Is epiglottis surgery necessary for obstructive sleep apnea patients with epiglottis obstruction? Laryngoscope 129(11):2658–2662
doi: 10.1002/lary.27808
pubmed: 30623431
Torre C, Camacho M, Liu SY, Huon LK, Capasso R (2016) Epiglottis collapse in adult obstructive sleep apnea: a systematic review. Laryngoscope 126(2):515–523
doi: 10.1002/lary.25589
pubmed: 26371602
Escourrou P, Grote L, Penzel T, McNicholas WT, Verbraecken J, Tkacova R et al (2015) The diagnostic method has a strong influence on classification of obstructive sleep apnea. J Sleep Res 24(6):730–738
doi: 10.1111/jsr.12318
pubmed: 26511017
Kezirian EJ, White DP, Malhotra A, Ma W, McCulloch CE, Goldberg AN (2010) Interrater reliability of drug-induced sleep endoscopy. Arch Otolaryngol Head Neck Surg 136(4):393–397
doi: 10.1001/archoto.2010.26
pubmed: 20403857