TY - JOUR
T1 - Efficacy of torus mandibularis resection in a patient with obstructive sleep apnea (OSA)
T2 - A case report
AU - Sato, Takako
AU - Nakamura, Ryota
AU - Ohtani, Saori
AU - Kusano, Akemi
AU - Kang, Serim
AU - Yanagawa, Keiichi
AU - Aoki, Junya
AU - Ogisawa, Shouhei
AU - Himejima, Akio
AU - Yamada, Takeya
AU - Tonogi, Morio
N1 - Publisher Copyright:
© 2018 Asian AOMS(+) ASOMP(+) JSOP(+) JSOMS(+) JSOM(+) and JAMI
PY - 2018/5
Y1 - 2018/5
N2 - Introduction: The aim of this study was to assess the contribution of a large torus mandibularis to induction of obstructive sleep apnea (OSA) due to upper-airway obstruction and to examine the efficacy of torus mandibularis resection in expanding the upper airway. Methods: The Japanese version of the Epworth Sleepiness Scale (JESS), unattended portable sleep monitoring and computed tomography (CT) were performed before and at 18 months after surgery. Result: The JESS score changed from 6 to 4. The lowest SpO2 and the percentage of time during which the SpO2 was <90% changed from 32% to 76% and from 8.23% to 2.08%, respectively. The 3% oxygen desaturation index (ODI) and respiratory disturbance index (RDI) at 18 months after surgery were 6.5 and 4.9 times/h, respectively. The upper-airway volume changed from 6,645.31 mm3 to 6,166.58 mm3 at the level of the posterior soft palate, and from 8,802.93 mm3 to 12,444.68 mm3 at the level of the posterior tongue. The volume enlargement ratio evident on 3D image reconstruction was 92.8% at the level of the posterior soft palate and 143.37% at the level of the posterior tongue. The distance from the apex linguae to the anterosuperior point of the hyoid changed from 60 mm to 65 mm, and the distance from the SN plane to the superior point of the dorsum linguae changed from 53 mm to 47 mm. Conclusion: Resection of a large torus mandibularis results in expansion of the upper- airway and may reduce airway obstruction during sleep.
AB - Introduction: The aim of this study was to assess the contribution of a large torus mandibularis to induction of obstructive sleep apnea (OSA) due to upper-airway obstruction and to examine the efficacy of torus mandibularis resection in expanding the upper airway. Methods: The Japanese version of the Epworth Sleepiness Scale (JESS), unattended portable sleep monitoring and computed tomography (CT) were performed before and at 18 months after surgery. Result: The JESS score changed from 6 to 4. The lowest SpO2 and the percentage of time during which the SpO2 was <90% changed from 32% to 76% and from 8.23% to 2.08%, respectively. The 3% oxygen desaturation index (ODI) and respiratory disturbance index (RDI) at 18 months after surgery were 6.5 and 4.9 times/h, respectively. The upper-airway volume changed from 6,645.31 mm3 to 6,166.58 mm3 at the level of the posterior soft palate, and from 8,802.93 mm3 to 12,444.68 mm3 at the level of the posterior tongue. The volume enlargement ratio evident on 3D image reconstruction was 92.8% at the level of the posterior soft palate and 143.37% at the level of the posterior tongue. The distance from the apex linguae to the anterosuperior point of the hyoid changed from 60 mm to 65 mm, and the distance from the SN plane to the superior point of the dorsum linguae changed from 53 mm to 47 mm. Conclusion: Resection of a large torus mandibularis results in expansion of the upper- airway and may reduce airway obstruction during sleep.
KW - Obstructive sleep apnea(OSA)
KW - Torus mandibularis
KW - Upper-airway
UR - http://www.scopus.com/inward/record.url?scp=85041680335&partnerID=8YFLogxK
U2 - 10.1016/j.ajoms.2018.01.002
DO - 10.1016/j.ajoms.2018.01.002
M3 - Article
AN - SCOPUS:85041680335
SN - 2212-5558
VL - 30
SP - 257
EP - 262
JO - Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
JF - Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
IS - 3
ER -