A Novel Method for Pre-selectivity of Oral Appliance Palliative Pharyngeal Airway Outcomes in Obstructive Sleep Apnea: A Pilot Study

Objectives: A qualified clinical solution improves preselective probabilities regarding who may successfully use an oral appliance (OA) for obstructive sleep apnea (OSA) for upright-awake oropharyngeal airway axial cross-sectional improvement.A discrete value method was constructed, measuring morphologic typology cone-beam computed tomography elements for OA use.Materials and Methods: Patients (n=20) in whom OSA was diagnosed and for whom OAs were prescribed were randomly selected for upright wakefulness airway imagery based on limited availability of imaging with and without OA placement.Cross-sectional axial airway areas were calculated and divided into "good" and "poor" responders (≥16% or <16%, respectively) for airway change.An OA evaluation index, using discrete scoring methods based on morphologic typology, was constructed to evaluate the effectiveness of OA usage for upright awake minimal axial airway dimension improvement, providing a predictive model for anatomic responder type.Results: Using the oral appliance efficacy index, "good" and "poor" responders for upright awake axial airway area increase was predicted at a 70% accuracy (P=.02) from derived two-dimensional cone-beam computed tomography cephalometric values without the inclusion of the middle pharyngeal muscle vector change and 75.5% (P=.05) when middle pharyngeal measures were included.Conclusion: Discrete scoring using cephalometric measures and middle pharyngeal muscle vector length change predicted OA palliative pharyngeal airway change.A 75.5% predictability for upright awake patients with OSA achieving a minimal cross-sectional axial airway area increase greater than or equal to 16% using an OA device was found, for a calculated 77.5% increase of airway flow.Clinical Implications: Who may increase airway dimensions is an effort, money, and time saver.