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Rodriguez Alcala C, Rodriguez Alcala L, Ignacio Garcia JM, Plaza G, Baptista P, Lujan G, Mazzei P, Ibañez-Rodriguez JA, O’Connor-Reina C. Use of Ultrasound to Verify the Impact of Telemedicine Myofunctional Therapy on Sleep Apnea Syndrome: Study Protocol Proposal. Life (Basel) 2024; 14:197. [PMID: 38398705 PMCID: PMC10890081 DOI: 10.3390/life14020197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/03/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
The anatomy of the upper airways influences the risk of obstructive sleep apnea (OSA). The size of soft tissue structures, such as the tongue, soft palate, and lateral walls of the pharynx, contributes to the pathogenesis of OSA. New lines of treatment for sleep apnea, such as myofunctional therapy (MT), aim to strengthen the oropharyngeal musculature to improve the defining parameters of apnea. The present protocol uses ultrasound imaging to measure the size of the lingual musculature non-invasively and cost-effectively and evaluates the changes in its morphology. Eligible patients include those with OSA who have undergone submental cervical ultrasound and drug-induced sleep endoscopy before starting MT with the AirwayGym app. Follow-up evaluations are conducted at 3 months after beginning treatment. Patients diagnosed with OSA via questionnaires and polysomnography or respiratory polygraphy are evaluated anatomically and functionally using the Iowa Oral Performance Instrument, a tongue digital spoon, somnoscopy, and submental cervical ultrasound to assess their responses to the AirwayGym app. The lingual thickness (mm) and volume (cm3) and the distance between both lingual arteries (mm) are measured. The AirwayGym app helps users and therapists monitor the patient performance of MT. Incorporating submental ultrasound can be a useful non-invasive tool to evaluate OSA and MT.
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Affiliation(s)
| | - Laura Rodriguez Alcala
- Otorhinolaryngology Department, Hospital Quironsalud Marbella, 29680 Marbella, Spain; (L.R.A.); (P.M.); (J.A.I.-R.)
- Otorhinolaryngology Department, Hospital Quironsalud Campo de Gibraltar, 11379 Palmones, Spain
| | | | - Guillermo Plaza
- Otorhinolaryngology Department, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, 28943 Madrid, Spain;
- Otorhinolaryngology Department, Hospital Sanitas la Zarzuela, 28023 Madrid, Spain
| | - Peter Baptista
- Otorhinolaryngology Department, Clínica Universitaria de Navarra, 31008 Pamplona, Spain
| | - Guillermina Lujan
- Otorhinolaryngology Department, Hospital Quironsalud Marbella, 29680 Marbella, Spain; (L.R.A.); (P.M.); (J.A.I.-R.)
- Otorhinolaryngology Department, Hospital Quironsalud Campo de Gibraltar, 11379 Palmones, Spain
| | - Paula Mazzei
- Otorhinolaryngology Department, Hospital Quironsalud Marbella, 29680 Marbella, Spain; (L.R.A.); (P.M.); (J.A.I.-R.)
- Otorhinolaryngology Department, Hospital Quironsalud Campo de Gibraltar, 11379 Palmones, Spain
| | - Juan Antonio Ibañez-Rodriguez
- Otorhinolaryngology Department, Hospital Quironsalud Marbella, 29680 Marbella, Spain; (L.R.A.); (P.M.); (J.A.I.-R.)
- Otorhinolaryngology Department, Hospital Quironsalud Campo de Gibraltar, 11379 Palmones, Spain
| | - Carlos O’Connor-Reina
- Otorhinolaryngology Department, Hospital Quironsalud Marbella, 29680 Marbella, Spain; (L.R.A.); (P.M.); (J.A.I.-R.)
- Otorhinolaryngology Department, Hospital Quironsalud Campo de Gibraltar, 11379 Palmones, Spain
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Jung TY, Lee E, Park M, Lee JY, Hong YS, Cho J, Guallar E, Hong SD, Jung YG, Gu S, Ryoo JW, Joo EY, Yeon JY, Ryu G, Kim HY. Obstructive Sleep Apnea and Its Influence on Intracranial Aneurysm. J Clin Med 2023; 13:144. [PMID: 38202154 PMCID: PMC10780116 DOI: 10.3390/jcm13010144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) is associated with cerebrovascular disease, which can lead to life-threatening outcomes. The purpose of the study was to investigate the relationship between OSAS and comorbid intracranial aneurysms. We retrospectively reviewed 564 patients who underwent a polysomnography and brain magnetic resonance angiography as part of their health checkup. We calculated the prevalence of an intracranial aneurysm and OSAS in patients and measured the size of the intracranial aneurysm if present. The mean patient age was 55.6 ± 8.5 years, and 82.3% of them were men. The prevalence of an intracranial aneurysm in patients with OSAS was 12.1%, which is significantly higher than patients with non-OSAS (5.9%, p = 0.031). Patients with OSAS had a much higher prevalence of intracranial aneurysms, after adjusting all possible confounding factors such as age, sex, smoking status, alcohol drinking, and body mass index (odds ratio: 2.32; 95% confidence interval: 1.07-5.04). Additionally, the OSAS group had noticeably larger aneurysms compared with those of the non-OSAS group (3.2 ± 2.0 mm vs. 2.0 ± 0.4 mm, p = 0.013). We found a significant association between OSAS and intracranial aneurysms. OSAS could be another risk factor for the development of intracranial aneurysms.
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Affiliation(s)
- Tae Young Jung
- Department of Otorhinolaryngology, Maryknoll Hospital, Busan 48972, Republic of Korea
| | - Eunkyu Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea (M.P.); (Y.G.J.)
| | - Minhae Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea (M.P.); (Y.G.J.)
| | - Jin-Young Lee
- Health Promotion Center, Samsung Medical Center, Seoul 06351, Republic of Korea;
| | - Yun Soo Hong
- Department of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul 06355, Republic of Korea;
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
- Department of Digital Healthcare, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul 06355, Republic of Korea
| | - Eliseo Guallar
- Department of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul 06355, Republic of Korea;
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Sang Duk Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea (M.P.); (Y.G.J.)
| | - Yong Gi Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea (M.P.); (Y.G.J.)
| | - Seonhye Gu
- Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea;
| | - Jae Wook Ryoo
- Department of Radiology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Eun-Yeon Joo
- Department of Neurology, Sleep Center, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea;
| | - Je Young Yeon
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea;
| | - Gwanghui Ryu
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea (M.P.); (Y.G.J.)
| | - Hyo Yeol Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea (M.P.); (Y.G.J.)
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Three-Dimensional Distance Mapping Method to Evaluate Mandibular Symmetry and Morphology of Adults with Unilateral Premolar Scissors Bite. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12125814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
(1) Objective: This study aimed to evaluate the association between unilateral premolar scissors bite and mandibular symmetry of adults via the 3D distance mapping method. (2) Methods: A total of 53 cone-beam computed tomography (CBCT) images of adults with unilateral premolar scissors bite were set as study samples. A total of 53 age- and sex-matched samples without scissors bite were in the control group. Three-dimensional mandibular models and seven mandibular functional units, including condylar process (Co), coronoid process (Cr), mandibular ramus (Ra), mandibular angle (Ma), alveolar process (Ap), mandibular body (Mb), and chin process (Ch) were constructed and mirrored. After superimposition of the original and the mirrored models, 3D distance maps and deviation analysis were performed to evaluate the mandibular symmetry and morphology. (3) Results: In the study group, the matching percentages of the entire mandible (50.79 ± 10.38%), Ap (67.00 ± 12.68%), Mb (66.62 ± 9.44%), Ra (62.52 ± 11.00%), Ch (80.75 ± 9.86%), and Co (62.78 ± 13.56) were lower than that of the entire mandible (58.60 ± 5.52) (p < 0.01), Ap (73.83 ± 8.88%) (p < 0.01), Mb (72.37 ± 8.69%) (p < 0.01), Ra (68.60 ± 7.56%) (p < 0.01), Ch (85.23 ± 6.80%) (p < 0.01), and Co (67.58 ± 10.32%) (p < 0.05) in the control group. However, Cr and Ma showed no significant difference (p > 0.05). (4) Conclusions: The 3D distance mapping method provided a qualitative and quantitative mandibular symmetry and morphology assessment. Mandibular asymmetry was found in adults with unilateral premolar scissors bites. Mandibular functional units, including the alveolar process, mandibular body, mandibular ramus, chin process, and condylar process, showed significant differences, while no significant difference was observed in the coronoid process and mandibular angle.
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Class II Treatment in Growing Patients: Preliminary Evaluation of the Skeletal and Dental Effects of a New Clear Functional Appliance. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The purpose of this retrospective preliminary study was to analyze the skeletal and dentoalveolar effects of a new clear functional appliance in a sample of patients close to growth spurt with class II malocclusion attributable to mandibular retrusion. Materials and methods: A sample of growing patients underwent functional Class II correction using F22® (Sweden and Martina, Due Carrare (PD), Italy) Young, realized combining the aesthetic characteristics of the F22® clear aligner with the structural features of a functional appliance. For each patient, a digital setup was performed by a single operator to plan a mandibular advancement to the therapeutic position. Cephalometric analysis before and after treatment was performed. The purpose of the statistical analysis was to evaluate dental and skeletal changes associated with F22® Young device, and whether there were statistically significant differences in anatomical measurements between the beginning and end of treatment. Results: 15 patients, 7 females and 8 males of average age 10.3, were treated with the F22® Young appliance for an average period of 10 months ± 0.5 (maximum 11.5 months, minimum 10.5 months). The data showed that the SNB angle increase was statistically significant from T0 to T1, leading to a reduction in the ANB angle. Values for the mandible length, both total (Co-Gn) and at the base (Go-Pg), significantly increased. Conclusions: According to this preliminary study, F22® Young appliance is effective in promoting mandibular advancement when used near the pubertal growth peak. The device is comfortable and aesthetic, which certainly promoted patient compliance, a key factor for treatment success.
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