Rp. Millman et al., THE EFFICACY OF ORAL APPLIANCES IN THE TREATMENT OF PERSISTENT SLEEP-APNEA AFTER UVULOPALATOPHARYNGOPLASTY, Chest, 113(4), 1998, pp. 992-996
Citations number
9
Categorie Soggetti
Respiratory System","Cardiac & Cardiovascular System
Twenty-four patients who failed uvulopalatopharyngoplasty (UPPP) for o
bstructive sleep apnea (OSA) had an adjustable oral (Herbst) appliance
made to treat the persistent apnea. Six patients discontinued the dev
ice prior to sleep evaluation. Eighteen patients had polysomnographic
evaluations at baseline, post-UPPP, and with the Herbst appliance in p
lace. The apnea-hypopnea index baseline (AHI) and arterial oxygen satu
ration (SaO(2)) nadir were 42.3+/-6.1 and 83.6+/-1.8%, respectively. T
here was no significant change in either parameter with surgery. With
the oral appliance, the AHI fell to 15.3+/-4.4 (p less than or equal t
o 0.01) and the SaO(2) nadir increased to 87.9+/-1.2% (p less than or
equal to 0.05). Ten of the patients had control of the OSA with the He
rbst appliance with a fall in the AHI to < 10. There were, in addition
, two partial responders as defined by an AHI of <20 and a >50% fall i
n AHI compared with baseline and post-UPPP values. All but one of the
responders and partial responders had complete resolution of subjectiv
e symptoms of daytime sleepiness with the appliance. An adjustable ora
l appliance appears to be an effective mode of therapy to control OSA
after an unsuccessful UPPP.