Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Usefulness of a Titratable Mandibular Positioner During Sleep Endoscopy as a Prediction Tool for Treatment Outcome with Mandibular Advancement Devices: DISE-SAM Protocol

Version 1 : Received: 26 December 2021 / Approved: 28 December 2021 / Online: 28 December 2021 (11:03:45 CET)

A peer-reviewed article of this Preprint also exists.

Fernández-Sanjuán, P.; Arrieta, J.J.; Sanabria, J.; Alcaraz, M.; Bosco, G.; Pérez-Martín, N.; Pérez, A.; Carrasco-Llatas, M.; Moreno-Hay, I.; Ríos-Lago, M.; Lugo, R.; O’Connor-Reina, C.; Baptista, P.; Plaza, G. Optimizing Mandibular Advancement Maneuvers during Sleep Endoscopy with a Titratable Positioner: DISE-SAM Protocol. J. Clin. Med. 2022, 11, 658. Fernández-Sanjuán, P.; Arrieta, J.J.; Sanabria, J.; Alcaraz, M.; Bosco, G.; Pérez-Martín, N.; Pérez, A.; Carrasco-Llatas, M.; Moreno-Hay, I.; Ríos-Lago, M.; Lugo, R.; O’Connor-Reina, C.; Baptista, P.; Plaza, G. Optimizing Mandibular Advancement Maneuvers during Sleep Endoscopy with a Titratable Positioner: DISE-SAM Protocol. J. Clin. Med. 2022, 11, 658.

Journal reference: J. Clin. Med. 2022, 11, 658
DOI: 10.3390/jcm11030658

Abstract

Mandibular advancement devices (MAD) are an effective alternative treatment to CPAP. However, different maneuvers have been performed during the performance of 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 to 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, a BMI of 27.90 (SD = 4.19) kg/m2 and a mean AHI of 26.51 (SD = 21.23). Results showed no relationship between severity and MAD recommendation. Also, 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 inter-examiner 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.

Keywords

sleep breathing disorders; mandibular advancement; MAD; titratable positioner; drug-induced sleep endoscopy; patient selection.

Subject

MEDICINE & PHARMACOLOGY, Other

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