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Effectiveness of Titratable Oral Appliance in Management of Moderate to Severe Obstructive Sleep Apnea—A Prospective Clinical Study with Acoustic Pharyngometry

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

To assess effectiveness of titratable Oral Appliance (OA) in management of moderate to severe cases of Obstructive Sleep Apnea (OSA). Thirty Polysomnography (PSG) diagnosed cases of moderate to severe OSA were subjected to a thorough cranio-facial-dental evaluation, a detailed sleep history and three dimensional assessment of upper airway geometry utilising Acoustic Pharyngometry (AP) (Eccovision, sleep group solutions). A titratable OA was delivered to all patients for mandibular advancement. Apnea Hypopnea Index (AHI), Oxygen Saturation (SPO2), Epworth's Sleepiness Scale (ESS), Mean area and volume of upper airway were recorded at Baseline (T0) and after 08 weeks of appliance delivery (T1). The mean AHI & ESS scores were significantly lower and SPO2 was significantly higher at T1 compared to T0 (P-value < 0.05 for all). The mean area and volume of upper airway at T1 were significantly higher compared to values at T0 (P-value < 0.05 for both). The mean area showed 19.51% increase at T1 whereas mean volume increased by 18.55%. OA therapy is highly efficacious in cases with moderate to severe OSA, especially, in those with retrognathic mandible. This modality should be considered as an effective alternate to Continuous Positive Airway Pressure (CPAP) therapy in non-compliant patients rather than no treatment. AP is an effective modality to predict airway changes after advancement with OA, to ascertain follow up changes and is highly recommended in routine clinical practice. Large scale, multicenter studies are recommended to elaborate the findings of the present study and to add better quality evidence in this regard.

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Authors and Affiliations

  1. Department of Orthodontics and Dentofacial Orthopedics, Armed Forces Medical College, Pune, India

    Shiv Shankar Agarwal, Sanjeev Datana & Pushkar Andhare

  2. Department of Oral and Maxillofcial Surgery, Armed Forces Medical College, Pune, India

    I. D. Roy

Authors
  1. Shiv Shankar Agarwal
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  2. Sanjeev Datana
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  3. I. D. Roy
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  4. Pushkar Andhare
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Correspondence to Shiv Shankar Agarwal.

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A written informed consent was obtained from all patients for participation in the present study.

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Agarwal, S.S., Datana, S., Roy, I.D. et al. Effectiveness of Titratable Oral Appliance in Management of Moderate to Severe Obstructive Sleep Apnea—A Prospective Clinical Study with Acoustic Pharyngometry. Indian J Otolaryngol Head Neck Surg 74, 409–415 (2022). https://doi.org/10.1007/s12070-021-02976-0

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  • DOI: https://doi.org/10.1007/s12070-021-02976-0

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