Altered inspiratory airway dilation patterns with mandibular advancement splints may help predict treatment outcomes

L. Jugé, J. Yeung , F. Knapman, P. Burke, E. Brown, J. Butler, D. J. Eckert, J. Ngiam, K. Sutherland, P. A. Cistulli, L. E. Bilston

Research output: Contribution to journalMeeting abstractpeer-review

Abstract

Introduction : Mandibular advancement increases the lateral dimensions of the nasopharynx via a direct connection between the lateral upper airway and the ramus of the mandible (Brown et al. Sleep 2013; 36:397–404). The aim of this study was to investigate whether a tendinous lateral connection influences the mechanical properties of the lateral walls, airway dimensions and treatment response. Methods : Detailed pharyngeal MRI of 105 people with obstructive sleep apnoea were examined to identify the presence of a tendinous connection between the mandible and the lateral airway. Length of the tendinous tract and airway dimensions were measured in the neutral and advanced positions using a temporary device. Participants were supplied with a custom- fitted Mandibular advancement splint (MAS) and treatment response was assessed after acclimatization. Results : 63% of participants had a tendinous lateral connection. The amount of possible mandibular advancement was greater in the non- tendon group (4.6 ± 1.4 mm absent vs. 4.0 ± 1.2 mm present, p = 0.04) with midline antero- posterior airway dimension also greater (1.6 ± 1.7 mm non- tendon vs. 0.6 ± 2.3 mm, p = 0.04). The non- tendon group were more likely to have a complete response to MAS (treatment AHI < 10 events/hr, 44% vs. 32%) but were less likely to complete acclimatization (69% vs. 88%, χ2 (3) = 10.578, p = 0.014). Conclusion : A tendinous lateral tract was associated with smaller achievable amount of mandibular advancement. People without detectable tendon were more likely to have a complete response to MAS treatment, but were less likely to tolerate MAS for reasons that are incompletely understood.
Original languageEnglish
Article numberO031
Number of pages1
JournalJournal of Sleep Research
Volume28
Issue numberSupplement 1
DOIs
Publication statusPublished - Oct 2019
Externally publishedYes
EventSleep DownUnder 2019, 31st Annual Scientific Meeting of Australasian Sleep Association and the Australasian Sleep Technologists Association - Sydney, Australia
Duration: 16 Oct 201919 Oct 2019

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