Choakchai Metheetrairut

Adjustable thermoplastic mandibular advancement device for obstructive sleep apnea: Outcomes and practicability

To assess outcomes including efficacy, adverse effects, and quality of life (QOL) of an adjustable thermoplastic mandibular advancement device (AT‐MAD) fitted by an otolaryngologist for obstructive sleep apnea (OSA) treatment.

Lateral cephalometric analysis and the risks of moderate to severe obstructive sleep-disordered breathing in Thai patients

PurposesThis cross-sectional study was aimed to compare lateral cephalometric parameters among patients with different severities of obstructive sleep-disordered breathing and to determine if there are radiographic variables that increase risk of moderate to severe obstructive sleep apnea (OSA).MethodsTen linear and 5 angular parameters of lateral cephalometry in 188 adult subjects which included 47 controls and 141 patients with OSA classified by apnea–hypopnea index (AHI) from level-I polysomnography, were analyzed. All radiographs were done under standardized processes and measured twice on separate occasions.ResultsThere were statistically significant differences between controls and patients with AHI ≥ 15 in parameters such as a distance from mandibular plane to hyoid (MP-H), posterior airway space (PAS), skull base angle (NSBA), a distance from posterior nasal spine to posterior pharyngeal wall (PNS-PP), and soft palate length (PNS-P), (p < 0.01). However, no significant difference was found between controls and mild OSA. Logistic regression analysis showed that only MP-H with cutoff point of ≥ 18 millimeters, NSBA ≤ 130°, and PAS ≤ 10 millimeters were independent cephalometric variables that increased risk of having AHI ≥ 15 compared to controls with adjusted odds ratio of 17.1, 8.3 and 4.2, respectively. Gender did not significantly associate with OSA severity in this analysis.ConclusionsPatients who had longer MP-H, narrower PAS and narrower NSBA than specific cutoff points significantly increased risks of moderate to severe OSA. Treatments that effectively improve these parameters, particularly at tongue base level (MP-H and PAS), may decrease the severity of disease.

Adjustable thermoplastic oral appliance versus positive airway pressure for obstructive sleep apnea

To compare outcomes of continuous positive airway pressure (CPAP) and the adjustable thermoplastic mandibular advancement splint (AT‐MAS) for obstructive sleep apnea treatment.