Evidence map›Paper›PMID 32267227›Full record

ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2020

The relationship between specific nasopharyngoscopic features and treatment deterioration with mandibular advancement devices: a prospective study.

Eli Van de Perck, Sara Op de Beeck, Marijke Dieltjens, Anneclaire V Vroegop, Annelies E Verbruggen, Marc Willemen, Johan Verbraecken, Paul H Van de Heyning, Marc J Braem, Olivier M Vanderveken

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01532050 (PROMAD), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.7field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01532050 phase4completednot on this map

PROMAD : Predicting Therapeutic Outcome of Mandibular Advancement Device Treatment in Obstructive Sleep Apnea

TypeinterventionalSponsorethisch.comite@uza.beRan2012 to 2015Enrolled100ConditionsObstructive Sleep Apnea SyndromeArmsMandibular Advancement Device ( MAD)
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Polysomnographic phenotypes: predictors of treatment response in Obstructive Sleep Apnea with Mandibular Advancement devices.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
    Trial
  2. Review
  3. Article
  4. Article
  5. Role of drug-induced sleep endoscopy in evaluation of positional vs non-positional OSA.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Eli Van de PerckFaculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
Sara Op de BeeckFaculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
Marijke DieltjensFaculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
Anneclaire V VroegopFaculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
Annelies E VerbruggenDepartment of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.
Marc WillemenMultidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Edegem, Belgium.
Johan VerbraeckenFaculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
Paul H Van de HeyningFaculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
Marc J BraemFaculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
Olivier M VandervekenFaculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
Antwerp University Hospital · BEUniversity of Antwerp · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

objectivesThe variable efficacy of mandibular advancement device (MAD) treatment necessitates both accessible and accurate methods for patient selection. However, the role of awake nasopharyngoscopy for this purpose remains dubious. We introduced an assessment method based on anatomical upper airway features during tidal breathing for nasopharyngoscopy. The current study aimed to relate these features to MAD treatment outcome.

methodsOne hundred patients diagnosed with obstructive sleep apnea were prospectively recruited for MAD treatment in a fixed 75% degree of maximal protrusion. Nasopharyngoscopic observations during Müller's maneuver and tidal breathing were recorded both with and without MAD. Treatment outcome, confirmed by 3-month follow-up polysomnography with MAD, was classified as (1) apnea-hypopnea index reduction ≥ 50%, (2) treatment apnea-hypopnea index < 5 events/h, and (3) ≥ 10% increase in apnea-hypopnea index compared with baseline (treatment deterioration).

resultsA complete dataset was obtained in 65 patients. After adjusting for baseline apnea-hypopnea index, body mass index, and supine dependency, the position of the soft palate (odds ratio, 4.0; 95% confidence interval, 1.3-11.8; P = .013) and crowding of the oropharynx (odds ratio, 7.7; 95% confidence interval, 1.4-41.4; P = .017) were related to treatment deterioration. Addition of both features significantly (P = .031) improved the accuracy of baseline models based on clinical measurements alone. Moreover, with the MAD in situ, a posteriorly located soft palate (odds ratio, 9.8; 95% confidence interval, 1.7-56.3; P = .010) and a posteriorly located tongue base (odds ratio, 7.4; 95% confidence interval, 1.5-35.9; P = .013) were associated with treatment deterioration.

conclusionsAwake nasopharyngoscopy might be a valuable office-based examination to exclude the risk of treatment deterioration and improve patient selection for MAD treatment. CLINICAL

trial registrationRegistry: ClinicalTrials.gov; Name: Predicting Therapeutic Outcome of Mandibular Advancement Device Treatment in Obstructive Sleep Apnea (PROMAD); URL: https://clinicaltrials.gov/ct2/show/NCT01532050; Identifier: NCT01532050.

Indexed as

Mandibular AdvancementSleep Apnea, ObstructiveHumansPharynxPolysomnographyProspective StudiesTreatment OutcomeendoscopyMADobstructive sleep apneaoral applianceOSApredictionsoft palatetreatment outcome

Identifiers

PMID32267227
PMCPMC7954062
OpenAlexW3014678755

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.