Cho đến nay chỉ có ba trường hợp nghiên cứu đã được công bố cho thấy rằng các thiết bị bằng miệng có thể điều trị thành công bệnh nhân với UARS (71-73). Nghiên cứu thuần tập là cần thiết để xác nhận phát hiện này trong các quần thể lớn hơn. Phẫu thuật Năm 1996, Pepin et al | Snoring and Upper Airway Resistance Syndrome 315 define the treatment outcome for patients with UARS. According to this guideline only patients with PS are excluded from the need of follow-up sleep studies to document treatment outcome. So far only three case studies have been published showing that oral appliances can successfully treat patients with UARS 71-73 . Cohort studies are needed to confirm this finding in larger populations. Surgery In 1996 Pepin et al. 74 concluded that the studies on surgical intervention for UARS were descriptive rather than comparative. Recent studies on surgical intervention in UARS even include bariatric surgery 75 for UARS. According to the authors the patients in this study included six women with UARS who had a mean AHI of three events hour and a mean low oxyhemoglobin saturation of 84 . They also considered an ESS of 8 as the sole criterion for daytime somnolence. It appears that the criteria for a diagnosis of UARS were inappropriate aggravated by the fact that no BMI was mentioned for this subgroup. No follow-up outcomes were presented in this subgroup. Studies like this highlight the need for adherence to diagnostic criteria and randomized protocols especially when treatment modalities are chosen which are associated with surgical intervention where side effects and complications must be weighed against the potential gain. Surgery and Site of Upper Airway Collapse Different methods have been described to determine the site of collapse in the upper airway. These methods can be divided in those attempting to define the site of obstruction during wakefulness normal sleep and anesthesia-invoked sleep. Some of the techniques used include cephalometry fluoroscopy computed tomographic CT - and magnetic resonance MR -imaging acoustic reflection and nasopharyngoscopy. Surgical success for uvulopalatopharyngoplasty UPPP in OSA is only 5 in patients with an obstruction at the base of the tongue 76 . Since most patients present with .
