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Effectiveness of drug-induced sleep endoscopy in improving patients selection and outcomes of mandibular advancement device therapy for obstructive sleep apnea: a multicenter case-control study

Title: Effectiveness of drug-induced sleep endoscopy in improving patients selection and outcomes of mandibular advancement device therapy for obstructive sleep apnea: a multicenter case-control study
Authors: Iannella, Giannicola; Terranova, Sergio; Brunori, Marco; Vicini, Claudio; Caranti, Alberto; Campisi, Ruggero; De Ceglie, Vincenzo; Casale, Manuele; Moffa, Antonio; Salamanca, Fabrizio; Leone, Federico; De Vito, Andrea; Cammaroto, Giovanni; Cocuzza, Salvatore; Maniaci, Antonino; De Virgilio, Armando; Lechien, Jerome R; Chiesa-Estomba, Carlos-Miguel; Vaira, Luigi A; Boscolo-Rizzo, Paolo; Gargula, Stéphane; Costantino, Andrea; D'Ecclesia, Aurelio; Lombardo, Luca; Cremonini, Francesca; Bellizzi, Mario Giuseppe; Croce, Enrica; Polimeni, Antonella; Magliulo, Giuseppe; Pace, Annalisa
Contributors: Iannella, Giannicola; Terranova, Sergio; Brunori, Marco; Vicini, Claudio; Caranti, Alberto; Campisi, Ruggero; De Ceglie, Vincenzo; Casale, Manuele; Moffa, Antonio; Salamanca, Fabrizio; Leone, Federico; De Vito, Andrea; Cammaroto, Giovanni; Cocuzza, Salvatore; Maniaci, Antonino; De Virgilio, Armando; Lechien, Jerome R; Chiesa-Estomba, Carlos-Miguel; Vaira, Luigi A; Boscolo-Rizzo, Paolo; Gargula, Stéphane; Costantino, Andrea; D'Ecclesia, Aurelio; Lombardo, Luca; Cremonini, Francesca; Bellizzi, Mario Giuseppe; Croce, Enrica; Polimeni, Antonella; Magliulo, Giuseppe; Pace, Annalisa
Publisher Information: Elsevier Inc.; 1600 John F Kennedy Blvd, Philadelphia, PA 19103 Stati Uniti
Publication Year: 2026
Collection: Sapienza Università di Roma: CINECA IRIS
Subject Terms: case-control study; drug induced sleep endoscopy; mandibular advancement device; OSA treatment; obstructive sleep apnea
Description: Purpose: To evaluate, in Obstructive sleep apnea (OSA) patients, the use of pre-treatment drug-induced sleep endoscopy (DISE) as a patient selection tool, that could improve the outcomes of mandibular advancement device (MAD) therapy. A multicenter retrospective case-control study has been performed. Methods: A multicenter case-control study with two parallel arms was conducted to compare functional outcomes in patients undergoing MAD therapy. Group A (n = 118) received MAD therapy based solely on static clinical assessments, including dentoskeletal features, oropharyngeal anatomy, and upper airway endoscopy. Group B (n = 87) underwent pre-treatment DISE to dynamically evaluate the site, type, and pattern of upper airway collapse, thereby guiding patient selection for MAD therapy. Results: In Group A, the mean pre-treatment apnea-hypopnea index (AHI) was 28.1, decreasing significantly to 12.4 post-treatment (p = 0.0001). In Group B, the mean AHI decreased from 31.3 to 9.5 (p = 0.0001). The Delta apnea-hypopnea index (ΔAHI) was significantly greater in Group B (−21.7) than in Group A (−16.6; p = 0.04). Similarly, the Delta Oxigen desaturation index (ΔODI) was −18.6 in Group B versus −14.1 in Group A (p = 0.04). The therapeutic success rate was significantly higher in Group B (82.7 %) compared to Group A (60.1 %) (p = 0.001). Conclusion: In OSA patients, a pre-treatment DISE evaluation, improves the selection of appropriate candidates for MAD therapy by enabling dynamic assessment of upper airway collapsibility during a pharmacologically induced sleep. This targeted selection results in significantly better therapeutic outcomes for MAD therapy for the OSA treatment.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/41260021; info:eu-repo/semantics/altIdentifier/wos/WOS:001625635800001; volume:47; issue:1; firstpage:1; lastpage:8; numberofpages:8; journal:AMERICAN JOURNAL OF OTOLARYNGOLOGY; https://hdl.handle.net/11573/1757466
DOI: 10.1016/j.amjoto.2025.104740
Availability: https://hdl.handle.net/11573/1757466; https://doi.org/10.1016/j.amjoto.2025.104740
Rights: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.328EEE3E
Database: BASE