{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:05:37Z","timestamp":1793383537076,"version":"4.5.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T00:00:00Z","timestamp":1745625600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"\n Introduction:<\/jats:title>\n Mandibular advancement devices (MADs) are a treatment option for obstructive sleep apnea\/hypopnea syndrome (OSAHS); however, the ideal patient selection criteria continue to be refined.<\/jats:p>\n <\/jats:sec>\n \n Objectives:<\/jats:title>\n To determine the overall efficacy of a custom titratable MAD in treating a subset of OSAHS patients. A secondary objective was to determine predictive factors affecting treatment outcome for MAD therapy.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Retrospective analysis of a single otolaryngologist\u2019s (DCU) experience in 86 patients with Friedman Stages 2 to 4 treated with a MAD (Thornton Adjustable Positioner) at an academic medical center.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Therapeutic success as measured by type 3 home apnea test (HSAT) before and after proper MAD titration was defined as a 50% reduction in initial AHI or reduction of AHI to a mild severity below 15 events\/hour. The 50% AHI reduction rate after MAD titration was 64% and the overall success rate inclusive of patients with reduction below 15 events\/hour was 72.1%. MAD therapy significantly reduced the mean AHI (\u221210.4\u2009\u00b1\u200912.6),\n P<\/jats:italic>\n \u2009<\u2009.001) and improved the minimum oxygen saturation (1.88\u2009\u00b1\u20095.79,\n P<\/jats:italic>\n \u2009=\u2009.003). Significant reduction of OSAHS severity was seen across all treatment groups regardless of initial OSAHS severity: mild (55.9%), moderate (85%), severe (75%;\n P<\/jats:italic>\n \u2009<\u2009.001 for all 3 groups). High BMI, advanced age, concentric velopharyngeal collapse pattern, prior pharyngeal surgery, and male sex were not statistically significant predictors of ineffectiveness.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n MAD therapy for OSAHS in patients with Friedman Stages 2 to 4 is an effective treatment in 72% of cases and should be considered as an initial treatment option within this subset of patients, inclusive of those with initially severe, moderate, and mild OSAHS.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/00034894251334725","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T05:38:47Z","timestamp":1745645927000},"page":"575-582","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Patient Selection for Efficacious Mandibular Advancement Device Therapy in Obstructive Sleep Apnea: An Institutional Outcomes Analysis"],"prefix":"10.1177","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1043-8546","authenticated-orcid":false,"given":"Nainika","family":"Nanda","sequence":"first","affiliation":[{"name":"Division of Otolaryngology\u2014Head & Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of California Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1761-5303","authenticated-orcid":false,"given":"Aaron","family":"Robertson","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2014Head & Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5542-5994","authenticated-orcid":false,"given":"David C.","family":"Upton","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2014Head & Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,26]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/22.5.667"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2011.01.003"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200403000-00013"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.4858"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03045024"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00194809"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.8204"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29439"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.2948"},{"key":"e_1_3_3_11_2","unstructured":"Berry RB Brooks R Gamaldo CE et al The AASM manual for the scoring of sleep and associated events: rules terminology and technical specifications version 2.2. 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