HSC Section 3 - Trauma, Critical Care and Sleep Medicine

Snoring & Sleepiness Q Initial Final M H

Ghazal 2009 38 P 103 thermoplastic adjustable ‡ or custom-made adjustable § 25.9 6 2.9 24 (58) — ESS: IST, 7.5; TAP, 10.0 ESS: IST, 6.5*; TAP, 4.5* M Chan 2010 37 P 35 custom-made adjustable duobloc # — 1–1.5 (0) Transverse: 1 40% 6 10%; lateral: 1 25% 6 5%; anteroposterior: 17% 6 6% — — H Duarte 2012 31 P 15 adjustable 28.99 5 (0) — ESS: 9.5 ESS: 4.2* H Zhou & Llu 2012 39 P 16 custom-made adjustable monobloc 1 custom-made adjustable duobloc # 26.67 6 3.22 7 (0) UA space increased ESS: 11.88 6 2.68 ESS: monobloc, 7.88 6 2.31*; SILENT NITE, 8.00 6 2.50* H ESS: 7 6 4*; snoring: VAS, 3 6 2* H

Giannasi 2008 29 P 29 custom-made adjustable † 26.2 6 3.6 6 (0) — — Snoring decreased H Vanderveken 2008 34 monobloc 1 custom-made 28 6 4 9 (0) — Snoring: VAS, 8 6 2; ESS, 7 6 5 Snoring: VAS, cm, 2 6 3*; tp, 4 6 3*; ESS, cm, 5 6 4; tp, 6 6 4 — 1 (4) Nasopharynx: initial, 22.7 6 3.0; final, 24.8 6 2.1 — — H

Giannasi 2013 30 P 71 custom-made adjustable † 26.7 6 3.6 6–9 (8) — ESS: 13.0 ESS: 8.5* H adjustable 26.7 6 3.4 4–6 (4) — ESS: 8.7 6 4.9 ESS: 6.5 6 4.4* H Brown 2013 40 P 30 prefabricated fixed nylon # 29 6 6 — (2) Lateral dimension of UA increased — — M

Itzhaki 2007 28 PC 16 Herbst 28.0 6 3.1 12 (4) — ESS: 12.4 6 6.0 ESS: 7.8 6 3.8* H H

BMI 5 body mass index; cm 5 custom-made; ESS 5 Epworth Sleepiness Scale; H 5 high; M 5 medium; MAD 5 mandibular advancement device; P 5 prospective study; PC 5 prospective controlled study; Q 5 quality; TAP 5 Thornton Adjustable Positioner; tp 5 prefabricated; UA 5 upper airway; VAS 5 visual analogue scale.

— Snoring & sleepiness ceased

Sleepiness: VAS, Herbst, 2.0; Twin Block, 2.5*; ESS, Herbst, 8.0;

Twin Block, 8.5; snores/hr: Herbst, 64.0; Twin Block, 88.0

Dieltjens 2013 35 P 61 custom-made adjustable # 27.9 6 4.1 4 (4) — ESS: 10 6 5; snoring: VAS, 7 6 3

wall curvature reduced Lawton 2005 3 P 16 Twin Block 1 Herbst 29.2 1–1.5 (0) — Sleepiness: VAS, 3.0; ESS, 10.0; snores/hr: 144.0

Time, mo (Losses) Velopharynx Size

Tsuiki 2004 2 P 20 Klearway 27.8 6 4.9 6 (0) Velopharynx increased, anterior

TABLE II.

Follow-up

Type of Study No. and Type of MAD BMI, kg/m #

Effectiveness of Different Types of MAD by Velopharynx Size and Decrease in Snoring and Daytime Sleepiness.

adjustable duobloc

P 35 prefabricated

Poon 2008 36 P 14 thermoplastic

Banhiran 2014 32 P 64 prefabricated

‡ IST V R : Modified Herbst appliance. § TAP; # SomnoDent. k SILENT NITE. ¶ RespiDent Butterfly. **Elastoplast Sport.

* P < .05. † Adjustable PM Positioner.

Study

Laryngoscope 126: February 2016

Serra-Torres et al.: Oral Appliances for Sleep Apnea

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