수면무호흡증 환자에서 상부기도의 협착 부위 및 순응성이 하악전방이동장치에 의한 치료효과에 미치는 영향 = The Effects of Obstruction Site and Collapsibility of the Upper Airway on Treatment Outcome of the Mandibular Advancement Device in the Patients with Obstructive Sleep Apnea

다국어 초록 (Multilingual Abstract)

Background and Objectives: The upper airway caliber shows rhythmic changes according to the respiratory cycle. The dynamic imaging technique is needed to demonstrate nonfixed oropharyngeal obstruction in patients with snoring and/or obstructive sleep apnea. This study was designed to determine the level, extent, and dynamics of the oropharyngeal closure from the dynamic view of the oropharynx and to assess the treatment outcome of the mandibular advancement device according to obstruction site and collapsibility of the oropharynx
Materials and Method: The upper airway was scanned in 16 patients by using EBT while awake, asleep, with and without insertion of mandibular advancement device at least during 2 respiratory cycles. Portable polysomnography was performed before and after treatment.
Results: Of 16 subjects 8 showed obstruction at velopharynx, 5 at oropharynx, and 3 at both of the velopharynx and oropharynx. The mean RDI decreased from 24.79±14.79 to 13.22±13.92 after treatment. The amount of RDI decrease is 37.86% in velopharyngeal obstruction group and 61.87% in oropharyngeal obstruction group.
Conclusion: A mandibular advancement device is effective in decreasing obstructive sleep apnea during sleep wherever the obstruction occurs at velopharynx or oropharynx. Nevertheless, it is more effective in the patients with oropharyngeal obstruction rather than the patients with velopharyngeal obstruction.

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