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A pilot study on comparison of subjective titration versus remotely controlled mandibular positioning during polysomnography and drug-induced sleep endoscopy, to determine the effective protrusive position for mandibular advancement device therapy.
Kazemeini, Elahe; Op de Beeck, Sara; Vroegop, Anneclaire; Van Loo, Dorine; Willemen, Marc; Verbraecken, Johan; Braem, Marc J; Vanderveken, Olivier M; Dieltjens, Marijke.
Afiliación
  • Kazemeini E; Faculty of Medicine and Health Sciences, Translational Neurosciences, University of Antwerp, Universiteitsplein 1 - D.T.493, 2610, Wilrijk, Antwerp, Belgium.
  • Op de Beeck S; Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium.
  • Vroegop A; Faculty of Medicine and Health Sciences, Translational Neurosciences, University of Antwerp, Universiteitsplein 1 - D.T.493, 2610, Wilrijk, Antwerp, Belgium.
  • Van Loo D; Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium.
  • Willemen M; Faculty of Medicine and Health Sciences, Translational Neurosciences, University of Antwerp, Universiteitsplein 1 - D.T.493, 2610, Wilrijk, Antwerp, Belgium.
  • Verbraecken J; Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium.
  • Braem MJ; Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Edegem, Belgium.
  • Vanderveken OM; Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium.
  • Dieltjens M; Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Edegem, Belgium.
Sleep Breath ; 26(4): 1837-1845, 2022 12.
Article en En | MEDLINE | ID: mdl-35064876
STUDY OBJECTIVES: The aim of this pilot study was to evaluate the clinical effectiveness of subjective titration versus objectively guided titration during polysomnography (PSG) and drug-induced sleep endoscopy (DISE) in mandibular advancement device (MAD) therapy for patients with obstructive sleep apnea (OSA). METHODS: In this pilot cross-over study, patients underwent three titration procedures in randomized order: (1) subjective titration, (2) PSG-guided titration using a remotely controlled mandibular positioner (RCMP) and (3) DISE-assisted titration using RCMP. After each titration procedure, patients used the MAD for 1 month at the targeted protrusion obtained according to the preceding titration procedure. For each procedure, a follow-up PSG was performed after 1 month of MAD use in order to evaluate the efficacy of the MAD. RESULTS: Ten patients were included in the study. Overall, no significant differences in targeted optimal protrusion compared to maximal comfortable protrusion among the three titration methods were observed. There was no significant difference in reduction in AHI. In this study, PSG titration correctly classified 50% of patients as 'responder'. A higher predictive accuracy was found for DISE titration with a sensitivity of 83.3% and a specificity of 100%. CONCLUSIONS: This pilot randomized cross-over trial showed no differences in optimal mandibular positioning and corresponding efficacy of MAD between subjective titration, DISE titration or PSG titration.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Avance Mandibular Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Humans Idioma: En Revista: Sleep Breath Asunto de la revista: NEUROLOGIA / OTORRINOLARINGOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Avance Mandibular Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Humans Idioma: En Revista: Sleep Breath Asunto de la revista: NEUROLOGIA / OTORRINOLARINGOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Alemania