TY - JOUR
T1 - Optimizing Mandibular Advancement Maneuvers during Sleep Endoscopy with a Titratable Positioner
T2 - DISE-SAM Protocol
AU - Fernández-Sanjuán, Patricia
AU - Arrieta, Juan José
AU - Sanabria, Jaime
AU - Alcaraz, Marta
AU - Bosco, Gabriela
AU - Pérez-Martín, Nuria
AU - Pérez, Adriana
AU - Carrasco-Llatas, Marina
AU - Moreno-Hay, Isabel
AU - Ríos-Lago, Marcos
AU - Lugo, Rodolfo
AU - O’connor-Reina, Carlos
AU - Baptista, Peter
AU - Plaza, Guillermo
N1 - Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Mandibular advancement devices (MAD) are an effective alternative treatment to CPAP. Different maneuvers were performed during drug sleep-induced endoscopy (DISE) to mimic the effect of MAD. Using the Selector Avance Mandibular (SAM) device, we aimed to identify MAD candidates during DISE using a titratable, reproducible, and measurable maneuver. This DISE-SAM protocol may help to find the relationship between the severity of the respiratory disorder and the degree of response and determine the advancement required to improve the collapsibility of the upper airway. Explorations were performed in 161 patients (132 males; 29 females) with a mean age of 46.81 (SD = 11.42) years, BMI of 27.90 (SD = 4.19) kg/m2, and a mean AHI of 26.51 (SD = 21.23). The results showed no relationship between severity and MAD recommendation. Furthermore, there was a weak positive relationship between the advancement required to obtain a response and the disease severity. Using the DISE-SAM protocol, the response and the range of mandibular protrusion were assessed, avoiding the interexaminer bias of the jaw thrust maneuver. We suggest prescribing MAD as a single, alternative, or multiple treatment approaches following the SAM recommendations in a personalized design.
AB - Mandibular advancement devices (MAD) are an effective alternative treatment to CPAP. Different maneuvers were performed during drug sleep-induced endoscopy (DISE) to mimic the effect of MAD. Using the Selector Avance Mandibular (SAM) device, we aimed to identify MAD candidates during DISE using a titratable, reproducible, and measurable maneuver. This DISE-SAM protocol may help to find the relationship between the severity of the respiratory disorder and the degree of response and determine the advancement required to improve the collapsibility of the upper airway. Explorations were performed in 161 patients (132 males; 29 females) with a mean age of 46.81 (SD = 11.42) years, BMI of 27.90 (SD = 4.19) kg/m2, and a mean AHI of 26.51 (SD = 21.23). The results showed no relationship between severity and MAD recommendation. Furthermore, there was a weak positive relationship between the advancement required to obtain a response and the disease severity. Using the DISE-SAM protocol, the response and the range of mandibular protrusion were assessed, avoiding the interexaminer bias of the jaw thrust maneuver. We suggest prescribing MAD as a single, alternative, or multiple treatment approaches following the SAM recommendations in a personalized design.
KW - Drug-induced sleep endoscopy
KW - MAD
KW - Mandibular advancement
KW - Patient selection
KW - Sleep breathing disorders
KW - Titratable positioner
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U2 - 10.3390/jcm11030658
DO - 10.3390/jcm11030658
M3 - Article
AN - SCOPUS:85123394595
VL - 11
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 3
M1 - 658
ER -