Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

AERODYNAMIC STUDY WITH AND WITHOUT WEARING SLEEP SPLINT FOR SNORING

코골이용 sleep splint 장착 전후의 공기역학적인 연구

  • Jeong, Kil-Jung (Department of Oral & Maxillofacial surgery, School of Dentistry, Chon-buk National University) ;
  • Leem, Dae-Ho (Department of Oral & Maxillofacial surgery, School of Dentistry, Chon-buk National University) ;
  • Lee, Jong-Seok (Department of Oral & Maxillofacial surgery, School of Dentistry, Chon-buk National University) ;
  • Baek, Jin-A (Department of Oral & Maxillofacial surgery, School of Dentistry, Chon-buk National University) ;
  • Ko, Seung-O (Department of Oral & Maxillofacial surgery, School of Dentistry, Chon-buk National University) ;
  • Shin, Hyo-Keun (Department of Oral & Maxillofacial surgery, School of Dentistry, Chon-buk National University) ;
  • Kim, Hyun-Ki (Reaearch Institute of Speech Science, Chon-buk National University)
  • 정길중 (전북대학교 치의학 전문대학원 구강악안면외과) ;
  • 임대호 (전북대학교 치의학 전문대학원 구강악안면외과) ;
  • 이종석 (전북대학교 치의학 전문대학원 구강악안면외과) ;
  • 백진아 (전북대학교 치의학 전문대학원 구강악안면외과) ;
  • 고승오 (전북대학교 치의학 전문대학원 구강악안면외과) ;
  • 신효근 (전북대학교 치의학 전문대학원 구강악안면외과) ;
  • 김현기 (전북대학교, 음성과학 연구소)
  • Published : 2007.07.31
Download PDF
⟨ Previous Next ⟩

Abstract

If there are problems for us to sleep, we are faced with fatigue and dizziness in the day. Snoring and OSAS (obstructive sleep apnea syndrome) during sleeping are the main cause of sleep disorder. Treatments through surgical method and sleep splint can be performed to treat snoring and OSAS. Relapse of snoring and OSAS is common after treatment by surgical method. But, Recently sleep splint is frequently applied to treat snoring and OSAS with surgical treatment, because it is convenient and conservative. Sleep splint treat snoring and OSAS by ensuring airway through nose. As first step of fabrication occlusal bite is gained at a point that patient get feeling of increased nasal breathing in supined position, and next, the bite is transfered to sleep splint. This study surveyed the effect of sleep splint by questionnaire to the out-patients (the Dept. of Oral and Maxillofacial Surgery, Chonbuk National University Hospital) weared sleep splint and their partners, secondarily measured airflow through nose by aerophone II after wearing sleep splint and finally evaluated the effect of treatment of snoring and OSAS by sleep splint. The obtained result were as follows; 1. Though 'sleep splint' couldn't eliminate fundamental problems of snoring, it could improve the symptoms when patients were selected could using the 'Nakagawa's respiration method'. 2. Patients who used the sleep splint could breathe stably when patients are sleeping stably. Wearing a 'sleep splint' improved airflow by expanding the upper airway. 3. Even though sleep splint can be made with variable materials, the patients expressed the most satisfaction on the splint with '0.75mm hard shell'. 4. The 'Herbst' may allows the mandible to move the TMJ to relax. Nevertheless, some patients experienced a discomfort or irritation. 5. In Snoring and OSAS cases, it is recommended that patients should first explore non-surgical options prior to choosing a surgical treatment.

Keywords

References

  1. George PT : A modified functional appliance for treatment of obstructive sleep apnea. JCO 21 : 171, 1987
  2. Waite PD, Wooten V, Lanchner J et al : Maxillomandular advancement surgery in 23 patients with obstructive sleep apnea syndrome. J Oral Maxillofac Surg 47 : 1256, 1989 https://doi.org/10.1016/0278-2391(89)90719-2
  3. Block AJ, Fulker JA, Hughes AL et al : Factors influencing airway closure. Chest 86 : 114, 1984 https://doi.org/10.1378/chest.86.1.114
  4. Simmon FB, Guilleminault C, Silvestri R : Snoring and some obstructive sleep apnea can be cured by oropharyngeal surgery. Arch Otolaryngol 109 : 503, 1983 https://doi.org/10.1001/archotol.1983.00800220009003
  5. Guilleminault C, Eldridge FL, Dement WC : Insomnia with sleep apnea : A new syndrome. Science 181 : 856, 1973 https://doi.org/10.1126/science.181.4102.856
  6. Standard of practice committee of Americal Sleep Disorders Association ; Practice parameters for the idications for polysomnography and related procedures. Sleep 20 : 406, 1997 https://doi.org/10.1093/sleep/20.6.406
  7. Norton PG, Dunn EV : Snoring as a risk factor for disease : An epidemiological survey. Brit Med J 291 : 630, 1985 https://doi.org/10.1136/bmj.291.6496.630
  8. D'Alessandro R, Magaeli C, Gamberini G et al : Snoring everynight as a risk factor for myocardial infarction : a case control study. Brit Med J 300 : 1557, 1990
  9. Fujita S : UVPP for sleep apnea and snoring. Ear Nose Throat J 63 : 74, 1984
  10. Fujita S, Conway W, Zorick F et al : Surgical correction of anatomic abnormalties in obstructive sleep apnea syndrome : uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 89 : 923, 1981 https://doi.org/10.1177/019459988108900609
  11. Kamami YV : Laser CO2 for snoring : preliminary results. Acta Otorhinolaryngol Belg 44 : 451, 1990
  12. Iseri M, Balcioglu O : Radiofrequency versus injection snoreplasty in simple snoring. Otolaryngology Head and Neck Surgery 133 : 224, 2005 https://doi.org/10.1016/j.otohns.2005.04.018
  13. Li KK, Powell NB, Riley RW et al : Radiofrequency volumetric reduction of the palate : An extended follow-up study. Otolalyngol Head Neck Surg 122 : 410, 2000 https://doi.org/10.1016/S0194-5998(00)70057-X
  14. Troell RJ, Powell NB : Comparison of postoperative pain between laser-assisted uvlopalatopharyngoplasty, and radiofriquency volumetric tissue reduction of the palate. Otolaryngol Head Neck Surg 122 : 402, 2000 https://doi.org/10.1016/S0194-5998(00)70056-8
  15. Magit AE, Zapata Syboney : Radiofrequency ablation for the treatment of upper airway obstruction in pediatric patients. Operative Techniques in Otolaryngology 16 : 257, 2005 https://doi.org/10.1016/j.otot.2005.05.006
  16. Sullivan CE, Berthon JM, Issa FG et al : Reversal of obstructive sleep apnea by continuous positive airway pressure applied through the nares. Lancet 1 : 862, 1981
  17. Sanders MH, Moore SE, Eveslaae J : CPAP via nasal mask ; A treatment for occlusive sleep apnea. Chest 83 : 144, 1983 https://doi.org/10.1378/chest.83.1.144
  18. Kenzo N : Treatment of snoring and OSAS by dental method : by Sunashobo Publishers, Co. Ltd, 1999
  19. Aidar LA, Abrah̃ao M, Yamashita HK et al : Herbst appliance therapy and temporomandibular joint disc position : A prospective longitudinal magnetic resonance imaging study. American Journal of Orthodontics and Dentofacial Orthopedics 129 : 486, 2006 https://doi.org/10.1016/j.ajodo.2005.01.019
  20. Cahill LM, Murdoch BE, McGahan T et al.: Preceptual and instrumental evaluation of voice and tongue function after carotid endarterectomy. J Vasc Surg 39 : 742, 2004 https://doi.org/10.1016/j.jvs.2003.12.028
  21. Perry CK, Ingrisano DRS, Scott SRG : Accuracy of jitter estimate using different filter settings on Visi-Pitch : a preliminary report . J Vioce 10 : 337, 1996 https://doi.org/10.1016/S0892-1997(96)80024-5
  22. Dwire A, McCauley R : Repeated measures of vocal fundamental frequency perturbation obtained using the Visi-Pitch. J Voice 9 : 156, 1995 https://doi.org/10.1016/S0892-1997(05)80249-8
  23. Hong KH : The assessment of nasality with a nasometer and sound spectrography in patients with nasal polyposis. Otolaryngol Head Neck Surg 117 : 343, 1997 https://doi.org/10.1016/S0194-5998(97)70124-4
  24. Thorpy M, Chesson A, Derderian S et al : Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliance. American Sleep Disordes Association. Sleep 19 : 156, 1996 https://doi.org/10.1093/sleep/19.2.156
  25. Robertson CJ : Treatment of obstructive sleep apnea in edentulous patients-design of a combination appliance : a case study. N Z Dent J 94 : 123, 1998
  26. Meyer JB, Knudson RC : Fabrication of prosthesis to prevent sleep apnea in edentulous patients. J Prosthet Dent 63 : 448, 1990 https://doi.org/10.1016/0022-3913(90)90236-6
  27. National Commision on Sleep splint Disorders Research. Wake Up America : A National Sleep Alert.Dement WC, Chairman.Washington DC Gorverment Printing Officce, 1993
  28. Rama AN, Tekwani SH, Kushida CA : Sites of obstruction in obstructive sleep apnea. Chestt 122 : 1139, 2002 https://doi.org/10.1378/chest.122.4.1139
  29. Schmidit NW, Meade T, Hays M : Treatment of snoring and obstructive sleep apnea with a dental orthosis. Chest 99 : 1378, 1991 https://doi.org/10.1378/chest.99.6.1378
  30. Lowe AA : Dental appliance for the treatment of snoring and obstructive sleep apnea. In Kryger M, Roth T and Dement W(Eds) ; Principles and practice of sleep medicine. 2nd ed Philadelphia WB. Saunder Co. 1994, p.772
  31. Rose EC, Staats R, Virchow C et al : Occlusal and skeletal effects of an oral appliance in the treatment of obstructive sleep apnea. Chest 122 : 871, 2002 https://doi.org/10.1378/chest.122.3.871