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Effect of long-term oral appliance therapy on obstruction pattern in patients with obstructive sleep apnea

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Abstract

Purpose

Oral appliance therapy is an alternative treatment modality for obstructive sleep apnea (OSA). However, there have been no studies to determine whether changes in the obstructive pattern occur following long-term use of oral devices. Therefore, we examined whether the obstructive pattern changes in patients with OSA who undergo long-term oral appliance therapy using drug-induced sleep endoscopy (DISE).

Methods

We investigated 156 consecutive patients diagnosed with OSA. Seventy-nine of these patients were found to be eligible for inclusion in this study. All enrolled patients underwent two DISE examinations: before and after oral appliance use. We compared the DISE findings for each patient in terms of degree and configuration of airway obstruction at the levels of the velum, oropharynx, tongue base, and epiglottis.

Results

We found that dental problems, as assessed using the average values of overjet and overbite, were significantly decreased after 2 years of oral appliance use. Comparisons of the DISE findings revealed that there was significant widening of the upper airway structures following long-term oral appliance therapy, especially in the velum (P = 0.022) and epiglottis (P = 0.001). However, changes in the configuration of upper airway obstruction were not observed in any of the structures of the upper airway.

Conclusions

We found evidence possibly indicating decreased obstruction at the levels of the velum and epiglottis after long-term use of oral appliances. We suggest further cohort studies to confirm these findings.

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Acknowledgements

This research was supported by the Hallym University Research Fund (to Jo Seo Yun and Dong-Kyu Kim) and by the Hallym University Research Fund 2016 (HURF-2015-43, to Dong-Kyu Kim).

Funding

This research was supported by the Hallym University Research Fund (to Jo Seo Yun and Dong-Kyu Kim) and by the Hallym University Research Fund 2016 (HURF-2015-43, to Dong-Kyu Kim).

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Authors and Affiliations

  1. Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of Korea

    Seo Yun Jo & Dong-Kyu Kim

  2. Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77, Sakju-ro Chuncheon-si, Chuncheon, Gangwon-do, 200-704, Republic of Korea

    Sung Min Lee, Kang Hyun Lee & Dong-Kyu Kim

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  1. Seo Yun Jo
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Correspondence to Dong-Kyu Kim.

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The authors have indicated no financial conflicts of interest.

Ethical approval

The study protocol was approved by our Institutional Review Board, and all subjects provided written informed consent.

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Jo, S.Y., Lee, S.M., Lee, K.H. et al. Effect of long-term oral appliance therapy on obstruction pattern in patients with obstructive sleep apnea. Eur Arch Otorhinolaryngol 275, 1327–1333 (2018). https://doi.org/10.1007/s00405-018-4909-4

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  • DOI: https://doi.org/10.1007/s00405-018-4909-4

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