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Otolaryngology, ENT & Sinus News Provided by the California Sinus CentersDeterminants of Treatment Outcome After Use of the Mandibular Advancement Device in Patients With Obstructive Sleep Apnea [Original Article]July 1, 2010, 12:00 pm by Archives of Otolaryngology Head & Neck SurgeryObjective To determine the predictors affecting treatment outcome after application of the mandibular advancement device (MAD). Design Retrospective analysis. Setting Tertiary care university hospital. Patients A total of 76 patients (68 men and 8 women) who were treated with the MAD for obstructive sleep apnea (OSA) were included from September 2005 through August 2008. All the subjects underwent cephalometry, nocturnal polysomnography, and sleep videofluoroscopy (SVF) before and at least 3 months after receipt of a custom-made MAD. Sleep videofluoroscopy was performed before and after sleep induction and was analyzed during 3 states of awakeness, normoxygenation sleep, and desaturation sleep. Subjects were divided into success and nonsuccess groups depending on treatment outcome. Main Outcome Measures Multiple variables from cephalometry and SVF including the length of the soft palate, retropalatal space, retrolingual space, and mouth opening angle were evaluated during sleep events with or without the MAD between success and nonsuccess group. Results The soft palate was significantly longer in the nonsuccess group than in the success group. The retropalatal and retrolingual airway spaces and mouth opening angle were not different between 2 groups. Application of the MAD increased the retrolingual space and decreased the length of the soft palate and the mouth opening angle significantly in both success and nonsuccess groups. However, retropalatal space was widened only in the success group, which showed that retropalatal space may be important in determining treatment response of the MAD. Conclusion The length of the soft palate showed a difference between success and nonsuccess groups, and widening of retropalatal space might be an important factor for successful outcome with MAD application.
More from Archives of Otolaryngology Head & Neck Surgery Long-term Health-Related Quality of Life in Survivors of Head and Neck Cancer [Original Article] Archives of Otolaryngology Head & Neck Surgery: January 16, 2012, 12:00 pm Objective To examine health-related quality of life (HRQOL) reported by 5-year head and neck cancer survivors and factors that predicted these long-term scores. Design Prospective, observational outcomes study. Setting Tertiary care institution. Patients A total Sequential Bilateral Cochlear Implantation in Children: Quality of Life [Original Article] Archives of Otolaryngology Head & Neck Surgery: January 16, 2012, 12:00 pm Objective To assess the effect of sequential bilateral cochlear implantation in children on their quality of life (QoL). Design Prospective cohort-control study. Setting Tertiary academic referral center. Patients Thirty children with prelingual deafness underwent sequential Disinfection of Flexible Fiberoptic Laryngoscopes After In Vitro Contamination With Staphylococcus aureus and Candida albicans [Original Article] Archives of Otolaryngology Head & Neck Surgery: January 16, 2012, 12:00 pm Objective To determine the efficacy of various cleaning and disinfective methods in reducing bacterial and fungal load on flexible fiberoptic laryngoscopes (FFLs). Design In vitro model. Subjects Flexible fiberoptic laryngoscopes contaminated with Staphylococcus aureus Winter scene, Pittsburgh, Pennsylvania [About the Cover] Archives of Otolaryngology Head & Neck Surgery: January 1, 2012, 12:00 pm About This Journal [About This Journal] Archives of Otolaryngology Head & Neck Surgery: January 1, 2012, 12:00 pm
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