title: Sleep endoscopy with simulation bite for prediction of oral appliance treatment outcome.
abstract: The aim of this study was to assess the value of drug-induced sleep endoscopy (DISE) using a custom-made simulation bite in maximal comfortable protrusion (MCP) of the mandible, in the prediction of treatment outcome for obstructive sleep apnea (OSA) with a mandibular advancement device (MAD). Two hundred patients (74% male; age 46 ± 9 years; apnea-hypopnea index [AHI] 19 ± 13 h(-1) sleep; body mass index [BMI] 27 ± 4 kg m(-2) ) with sleep-disordered breathing underwent DISE with a simulation bite in MCP. One hundred and thirty-five patients with an established diagnosis of OSA commenced MAD treatment. The associations between the findings during DISE with simulation bite and treatment outcome were evaluated. Treatment response was defined as a reduction in AHI following MAD treatment of ≥ 50% compared to baseline. Overall MAD treatment response in the studied population was 69%. The results of this study demonstrated a statistically significant association between a positive effect of the simulation bite on the upper airway patency during DISE and treatment response with MAD (P < 0.01). The results of this study suggest that the use of a simulation bite in maximal comfortable protrusion (MCP) of the mandible, as used during DISE in patients with OSA, tends to be effective in predicting treatment response of MAD treatment.
authors.affiliation: Departments of ENT, Head and Neck Surgery, Antwerp University Hospital, Edegem, Wilrijkstraat 10, Antwerp, Belgium. anneclaire.vroegop@uza.be
authors.forename: Anneclaire V M T
authors.initials: AV
authors.lastname: Vroegop
authors.forename: Olivier M
authors.initials: OM
authors.lastname: Vanderveken
authors.forename: Marijke
authors.initials: M
authors.lastname: Dieltjens
authors.forename: Kristien
authors.initials: K
authors.lastname: Wouters
authors.forename: Vera
authors.initials: V
authors.lastname: Saldien
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Braem
authors.forename: Paul H
authors.initials: PH
authors.lastname: Van de Heyning
mesh_terms: D000328:Adult; D004724:Endoscopy / Q000295:instrumentation* / Q000379:methods; D004864:Equipment and Supplies / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000503:physiopathology; D019186:Mandibular Advancement / Q000295:instrumentation*; D008875:Middle Aged; D017286:Polysomnography; D011237:Predictive Value of Tests; D012890:Sleep / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000628:therapy; D016896:Treatment Outcome