Obstructive sleep apnea patients with the oral appliance experience pharyngeal size and shape changes in three dimensions.

Kyung, Seung Hyun; Park, Young-Chel; Pae, Eung-Kwon
The Angle orthodontist
2005Jan ; 75 ( 1 ) :15-22.
PMID : 15747810
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Kyung, Seung Hyun -
Park, Young-Chel -
Pae, Eung-Kwon -
ABSTRACT
Pharyngeal size and shape differences between pre- and posttrials of a mandible-protruding oral appliance were investigated using cine computerized tomography (CT). Fourteen patients diagnosed with obstructive sleep apnea whose apnea-hypopnea index was higher than 5 and arousal index higher than 20 underwent a second overnight sleep study to evaluate the effectiveness of the oral appliance. Three-dimensional changes in pharyngeal shape measured on cross-sectional CT images during two respiratory cycles after oral appliance delivery were estimated by three variables: (1) lateral dimension, (2) anterior-posterior dimension, and (3) cross-sectional area at five vertical levels. Apnea indices improved significantly when the appliance was used. During apnea, measurements at retropalatal and retroglossal levels decreased most. However, the cross-sectional area of these levels appeared to increase significantly (P < .05) with the appliance in place during wakefulness. The oral appliance appears to enlarge the pharynx to a greater degree in the lateral than in the sagittal plane at the retropalatal and retroglossal levels of the pharynx, suggesting a mechanism for the effectiveness of oral appliances that protrude the mandible.
OSA, Cine-CT
MESH
Cephalometry, Cineradiography, Continuous Positive Airway Pressure, Female, Humans, Male, Mandibular Advancement/*instrumentation, Middle Aged, *Occlusal Splints, Pharynx/*anatomy & histology/radiography, Polysomnography, Sleep Apnea, Obstructive/*therapy, Tomography, X-Ray Computed/methods
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This study conclude that airway enlargement in the lateral dimension may play a role in the mechanism of the oral appliance in reducing OSA.
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DOI
10.1043/0003-3219(2005)075<0015:OSAPWT>2.0.CO;2
KCDÄÚµå
ICD 03
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