Abstract

Upper airway resistance syndrome has become a prevalent form of sleep-disordered breathing. The causes for UARS include decreased pharyngeal muscle tone, and craniofacial deficiencies amongst others. Current methods used to manage UARS - include no standard medical treatment; continuous positive airway pressure (CPAP) therapy and/or mandibular advancement appliances have been used without any results. Therefore, this study is to test the hypothesis that a biomimetic oral appliance therapy (BOAT) can be used followed by a DNA appliance, with a forward facial head-gear mask. This pilot study included two adults: 2 females, 29 years and 32 years, (mean age 31yrs.) diagnosed with UARS to mild OSA who were treated with FDA-cleared BOAT (MRNA appliance®) followed with a forward facial mask for osseous remodeling. Prior to treatment the craniofacial region was imaged using 3D cone-beam CT scans. After 9 to 15 months of treatment, the upper airway volume was reassessd with 3D cone-beam CT scans and upper airway analysis. For case 1, the upper airway volume (from the posterior nasal spine to the epiglottis) prior to treatment was 9.28cm 3 and increased to 16cm 3, representing a 29% increase in upper airway volume. For case 2, upper airway volume increased from 16.7cm 3 prior to treatment to 20.5cm 3 post-treatment, showing a 12.5% increase in upper airway volume. By subjective questionnaires of before and after, the patients have improved immensely. This preliminary study indisputably suggests that increases in 3D airway may be associated with non-surgical upper airway remodeling for UARS in adults with craniofacial deficiencies. None

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