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Soft palate cephalometric changes with a mandibular advancement device may be associated with polysomnographic improvement in obstructive sleep apnea

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

It is unclear whether soft palate-associated changes in cephalometry associated with a mandibular advancement device (MAD) are independently associated with improvements in polysomnography (PSG) respiratory parameters in obstructive sleep apnea (OSA).

Methods

This retrospective review aimed to identify the association between soft palate-associated changes in cephalometry and PSG changes after application of an MAD. Korean patients diagnosed with OSA who underwent cephalometry with or without an MAD were enrolled. All the patients were evaluated after undergoing full-night PSG twice: once with an MAD and once without. Cephalometric findings were measured using an image analyzer.

Results

Mean apnea–hypopnea index significantly decreased with an MAD from 36.4/h to 14.7/h (p < 0.001). Retropalatal airway space significantly increased with an MAD from 6.6 to 7.3 mm (p = 0.013). Soft palate length also significantly decreased with an MAD from 43.6 to 42.3 mm (p = 0.02). Although these findings were shown by responders (patients with a reduction of apnea–hypopnea index by more than 50%), there were no significant changes in non-responders. However, retroglossal airway space did not significantly increase with an MAD even in responders.

Conclusions

Improvement of OSA with an MAD can be predicted with soft palate-associated upper airway changes shown in cephalometry.

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Funding

No funding was received for this research.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, South Korea

    Hong Joong Kim

  2. Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea

    Seung-No Hong

  3. Department of Otolaryngology, College of Medicine, Kangwon National University, Chuncheon, South Korea

    Woo Hyun Lee

  4. Department of Otorhinolaryngology, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, South Korea

    Jae-Cheul Ahn

  5. Department of Dentistry, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea

    Min-Sang Cha

  6. Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam, Gyeonggi-do, 13620, South Korea

    Chae-Seo Rhee & Jeong-Whun Kim

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  1. Hong Joong Kim
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Correspondence to Jeong-Whun Kim.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest in the subject matter or materials discussed in this manuscript.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Kim, H.J., Hong, SN., Lee, W.H. et al. Soft palate cephalometric changes with a mandibular advancement device may be associated with polysomnographic improvement in obstructive sleep apnea. Eur Arch Otorhinolaryngol 275, 1811–1817 (2018). https://doi.org/10.1007/s00405-018-5007-3

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  • DOI: https://doi.org/10.1007/s00405-018-5007-3

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