Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Antisnoring Effects of Adjustable Anterior Positioner: Case Study

조절성 전방이동형 코골이 방지장치의 효과

  • Kim, Ki-Suk (Department of Oral Medicine, Dental School, Dankook University)
  • 김기석 (단국대학교 치과대학 구강내과학교실)
  • Received : 2012.11.02
  • Accepted : 2012.11.22
  • Published : 2012.12.30
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Abstract

Oral appliances are a primary treatment option for snoring and mild to moderate obstructive sleep apnea (OSA) and are considered as an alternative for patients with severe OSA who have failed continuous positive airway pressure (CPAP) or upper airway surgery. But it is true that OAs have varying degrees of effectiveness depending on different oral appliances and the efficacy of OAs are established in some but not all patients. New oral appliance, which is one of Adjustable Anterior Positioners, was developed by Dept of Oral Medicine, Dental School, Dankook University. This is a report for treating severe OSA patient with a failure of previous uvulopalatopharyngoplasty using a new Adjustable Anterior Positioner, followed by significant success of controlling OSA.

구강내 장치 요법은 가벼운 혹은 중간 정도의 폐쇄성 수면 무호흡증의 일차 치료법이며 심한 폐쇄성 수면 무호흡증의 경우에도 CPAP 또는 수술요법에서 효과가 없을 때 좋은 대안적 치료법이 될 수 있다. 하지만 다양한 구강내 장치들마다 치료 효과가 다르며 또한 모든 환자들에서 효과를 기대하기 어려운 것도 사실이다. 본 연구는 목젖입천장인두절제술(uvulopalatopharyngoplasty, UPPP) 을 받았으나 증상의 개선이 없는 심한 폐쇄성 수면 무호흡증 (obstructive sleep apnea, OSA) 환자에서 단국대 치대 구강내과에서 개발한 구강내 조절성 하악전방이동형 코골이 방지장치 (Adjustable Anterior Positioner, AAP)를 사용하여 치료한 증례를 보고하고 그에 대한 고찰을 한다.

Keywords

References

  1. Isono S, Tanaka A, Sho Y, et al. Advancement of the mandible improves velopharyngeal airway patency. J Appl Physiol 1995;79:2132-2138.
  2. Ng AT, Gotsopoulos H, Qian J et al. Effect of oral appliance therapy on upper airway collapsibility in obstructive sleep apnea. Am J Respir Crit Care Med 2003; 68:238-241.
  3. Fleury B, Rakotonanahary D, Vincent G, Pelletier F, Meyer B, Lebeau B. Mandibular advancement titration for obstructive sleep apnea: optimization of the procedure by combining clinical and oximetric parameters. Chest 2004 May; 125(5):1761-7. https://doi.org/10.1378/chest.125.5.1761
  4. Eveloff SE, Rosenberg CL, Carlisle CC, Millman RP. Efficacy of a Herbst mandibular advancement device in obstructive sleep apnea. Amer J Respir Crit Care Med 149,905-909.
  5. Millman RP, Rosenberg CL, Carlisle CC, Kramer NR, Kahn DM, Bonitai AE. The efficacy of oral appliances in the treatment of persistent sleep apnea after uvulopalatophayngoplasty. Chest 1998;113:992-996 https://doi.org/10.1378/chest.113.4.992
  6. Ferguson KA, Cartwright R, Rogers R, Schmidt- Nowara W. Oral appliances for snoring and obstructive sleep apnea : a review. Sleep 2006 Feb;29(2):244-62.
  7. Tsai WH, Remmers JE, Brant R, Flemons WW, Davies J, Macarthur C. A decision rule for diagnostic testing in obstructive sleep apnea. Am J Respir Crit Care Med 2003 May 15;167(10):1427-32. https://doi.org/10.1164/rccm.200112-110OC
  8. Guilleminault C, Riley R, Powell N. Obstructive sleep apnea and abnormal cephalometric measurements. Implications for treatment. Chest 1984;86:793-794. https://doi.org/10.1378/chest.86.5.793
  9. Grunstein R, Wilcox I, Yang TS, Gould Y, Hedner J. Snoring and sleep apnea in men: Association with central obesity and hypertension. Int J Obes Relat Metab Disord 1993;17;533-540.
  10. Ferguson KA, Ono T, Lowe AA, Ryan CF, Fleetham JA. The relationship between obesity and craniofacial structure in obstructive sleep apnea. Chest 1995 Aug; 108(2);375-81. https://doi.org/10.1378/chest.108.2.375
  11. Johns MW. A new method for measuring daytime sleepiness: The Epworth sleepiness scale. Sleep 1991;14:540-545.
  12. Ferguson KA, Ono T, Lowe AA, Ryan CF, Fleetham JA. The relationship between obesity and craniofacial structure in obstructive sleep apnea. Chest 1995 Aug; 108(2):375-81. https://doi.org/10.1378/chest.108.2.375
  13. Tsuchiya M, Lowe AA, Pae EK, Feetham JA. Obstructive sleep apnea subtypes by cluster analysis. Am J Orthod Dentofacial Orthop 1992 Jun; 101(6): 533-42. https://doi.org/10.1016/0889-5406(92)70128-W
  14. Marklund M, Stenlund H, Franklin KA. Mandibular advancement devices in 630 men and women with obstructive sleep apnea and snoring. Chest 2004;125: 1270-1278. https://doi.org/10.1378/chest.125.4.1270