title: Impact of sleep nasendoscopy on the outcome of mandibular advancement splint therapy in subjects with sleep-related breathing disorders.
abstract: OBJECTIVE
  To evaluate the impact of positive sleep nasendoscopy, with simultaneous mandibular advancement, on the outcome of mandibular advancement splint therapy in 120 subjects with sleep-related breathing disorders.
  
  
  METHODS
  Overnight polysomnography and sleep nasendoscopy were performed prior to splint therapy. Follow-up sleep studies, with the appliance in situ, were undertaken for those patients with obstructive sleep apnoea. Subjective outcome measures assessed daytime sleepiness and snoring.
  
  
  RESULTS
  One hundred and seven (89 per cent) subjects completed the study. Follow-up sleep studies confirmed the efficacy of treatment, with patients showing a mean reduction in apnoea/hypopnoea index (from 18.9 to 4.9, p<0.001), Epworth sleepiness scale scores (from 11 to seven, p<0.001) and partner-recorded snoring scores (from 14 to eight, p<0.001).
  
  
  CONCLUSIONS
  Sleep nasendoscopy, with concomitant mandibular advancement to mimic the treatment effect, could be of prognostic value in determining successful mandibular advancement splint therapy.
authors.affiliation: Oral Growth and Development, Institute of Dentistry, Barts & The London Queen Mary's School of Medicine and Dentistry, London, UK. a.s.johal@qmul.ac.uk
authors.forename: A
authors.initials: A
authors.lastname: Johal
authors.forename: M P
authors.initials: MP
authors.lastname: Hector
authors.forename: J M
authors.initials: JM
authors.lastname: Battagel
authors.forename: B T
authors.initials: BT
authors.lastname: Kotecha
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000628:therapy*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation*; D008875:Middle Aged; D017090:Occlusal Splints; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012913:Snoring / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome