Device, Surgery Both Found Effective in Sleep ApneaLast Updated: May 20, 2009. The mandibular advancement device is effective in the treatment of most obstructive sleep apnea, while surgery should be reserved for patients in whom conservative treatments have failed, according to studies reported in the May issue of the Archives of Otolaryngology: Head & Neck Surgery.
WEDNESDAY, May 20 (HealthDay News) -- The mandibular advancement device (MAD) is effective in the treatment of most obstructive sleep apnea (OSA), while surgery should be reserved for patients in whom conservative treatments have failed, according to studies reported in the May issue of the Archives of Otolaryngology: Head & Neck Surgery.
In the first study, Chul Hee Lee, M.D., of Seoul National University College of Medicine in Korea, and colleagues conducted a retrospective analysis of the efficacy of the MAD in 50 Korean OSA patients from 2005 to 2007. For patients using the device, the mean apnea-hypopnea index (AHI) decreased from 36.6 to 12.3. The treatment success rate (defined as AHI below 20 and a 50 percent AHI decrease) was 74 percent overall, 43 percent for mild OSA, 82 percent for moderate OSA, and 75 percent for severe OSA.
In the second study, Neville Patrick Shine, of St. John's Hospital in Edinburgh, United Kingdom, and colleagues studied medical records for 60 patients from 2002 to 2006 who underwent transpalatal advancement pharyngoplasty surgery to increase airway size to relieve OSA. After surgery, the mean respiratory disturbance index decreased from 37.2 to 15.4, and the mean arterial oxygen saturation nadir increased from 83.9 to 87.4 percent.
"To our knowledge, this is the largest series reported to date regarding the transpalatal advancement pharyngoplasty procedure. It should be considered in patients in whom conservative management has failed and who are willing to undergo surgery to improve the retropalatal airway," Shine and colleagues conclude.
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