Efficacy of orthodontic treatment versus adenotonsillectomy in children with moderate obstructive sleep apnoea and mandibular retrognathia: study design and protocol for a non-inferiority randomised controlled trial

Li, Yuanyuan; Lu, Yun; Li, Xuan; Zhao, Limin; Guo, Jinghan; Yu, Liming; Feng, Jia; Li, Bing; Li, Xiaoyan; Liu, Yuehua

doi:10.1136/bmjopen-2021-055964

Cited by 5 publications

(4 citation statements)

References 27 publications

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“…Orofacial myofunctional therapy can be considered as an effective complementary treatment for OSA patients with oral breathing after adenotonsillectomy 22 . Nowadays, a randomised, open-label, parallel-group, active controlled trial was designed to study the efficacy of orthodontic treatment versus adenotonsillectomy in children with mild or moderate OSA accompanied by tonsillar adenoid hypertrophy and mandibular retrognathia [23][24] . (ClinicalTrials.gov: NCT03451318).…”

Section: Orthodontic Appliance Accompanied With Orofacial Myofunction...mentioning

confidence: 99%

The Shanghai alliance of multilingual researchers: Fudan University, Tongji University, Shanghai University of Finance and Economics, and Shanghai International Studies University, China

et al. 2022

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Patient-independent detection of epileptic activities based on visual spectral representation of continuous EEG (cEEG) has been widely used for diagnosing epilepsy. However, precise detection remains a considerable challenge due to subtle variabilities across subjects, channels and time points. Thus, capturing fine-grained, discriminative features of EEG patterns, which is associated with high-frequency textural information, is yet to be resolved. In this work, we propose Scattering Transformer (ScatterFormer), an invariant scattering transform-based hierarchical Transformer that specifically pays attention to subtle features. In particular, the disentangled frequency-aware attention (FAA) enables the Transformer to capture clinically informative high-frequency components, offering a novel clinical explainability based on visual encoding of multichannel EEG signals. Evaluations on two distinct tasks of epileptiform detection demonstrate the effectiveness our method. Our proposed model achieves median AUCROC and accuracy of 98.14%, 96.39% in patients with Rolandic epilepsy. On a neonatal seizure detection benchmark, it outperforms the state-of-the-art by 9% in terms of average AUCROC.

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Section: Orthodontic Appliance Accompanied With Orofacial Myofunction...mentioning

confidence: 99%

The Shanghai alliance of multilingual researchers: Fudan University, Tongji University, Shanghai University of Finance and Economics, and Shanghai International Studies University, China

et al. 2022

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“…MADs can expand the upper airway as well as the forward migration of the jaw and hyoid bone. Numerous studies have demonstrated the steady long-term efficacy of RME and MAD in the treatment of juvenile OSA when used in the clinical setting, such as the Frankel and Twinblock apparatus [31].…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, risks from regular surgery and trauma may be connected to AT. The use of AT is a topic of intense discussion among medical experts [31].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effectiveness of Orthodontic Treatment with Adenotonsillectomy Procedures in Children with Obstructive Sleep Apnea (OSA)

Achmad¹

2022

J Dent Oral Sci

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Background: Obstructive Sleep Apnea Syndrome (OSA) is a syndrome of total or partial obstruction of the airways, leading to significant disturbances with varying clinical impact. In children, the main cause is thought to be overgrowth (hypertrophy) of the tonsils and adenoids, as well as structural abnormalities in Pierre Robin and Down Syndrome. The airway structures are significantly narrowed in children with head-face bone abnormalities or craniofacial anomalies, causing them to experience airway obstruction even in the absence of adenoid hypertrophy. The incidence of OSA in children needs to be observed as well as rising risk factors such as obesity. Pediatric obstructive sleep apnea (OSA) is typically treated with an adenotonsillectomy and the use of orthodontic procedures including rapid maxillary expansion and mandibular advancement devices. Each approach has different treatment advantages. Systematic reviews and meta-analysis of OSA treatments have been reported, however there have been relatively few comparisons of various treatments. In a systematic review of the evidence for the efficacy of AT and orthodontic treatment, Templier et al. concluded that combined AT orthodontic treatment (RME and/or MAD) was more effective than either therapy alone for treating OSA in pediatric patients. Objective: To systemically analyze the literature on the effectiveness of orthodontic treatment with adenotonsillectomy surgery in children with obstructive sleep apnea (OSA) and to identify differences in the two treatments’ effectiveness. Conclusion and implications: The effectiveness of adenotonsillectomy, orthodontic treatment, and orthodontic treatment combined with adenotonsillectomy was assessed in children with mild OSA and mandibular retrognathia. That study, which needed a large sample size (352 children) and had a high dropout rate, revealed that combine orthodontic adenotonsillectomy (RME and/or MAD treatment) was more effective when given simultaneously than when given individually for treating OSA in pediatric patients. To date, the effectiveness of these two treatments cannot currently be compared due to a lack of strong evidence. If the treatment outcomes were unsatisfactory at 7 months after the initial treatment, subjects could receive further treatment following assessment by a stomatologist and ear, nose, and throat (ENT) specialist. Limitations: Of the 10 publications included in this review, 8 were randomized controlled trials, the remaining 2 non-randomized research journals were vulnerable to many biases that impair the certainty of the evidence gained, especially by confounding factors and the lack of control groups.

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“…artículos(10)(11)(12)(13)(14)(15) fueron incluidos en esta revisión sistemática, tal y como se esquematiza en la figura 1.…”

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Dental approach for the management of obstructive sleep apnea in pediatric patients: a systematic review

García González,

Caleza Jiménez,

Ribas Pérez

2024

Odontol Pediatr

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Efficacy of orthodontic treatment versus adenotonsillectomy in children with moderate obstructive sleep apnoea and mandibular retrognathia: study design and protocol for a non-inferiority randomised controlled trial

Cited by 5 publications

References 27 publications

The Shanghai alliance of multilingual researchers: Fudan University, Tongji University, Shanghai University of Finance and Economics, and Shanghai International Studies University, China

The Shanghai alliance of multilingual researchers: Fudan University, Tongji University, Shanghai University of Finance and Economics, and Shanghai International Studies University, China

Comparison of the Effectiveness of Orthodontic Treatment with Adenotonsillectomy Procedures in Children with Obstructive Sleep Apnea (OSA)

Dental approach for the management of obstructive sleep apnea in pediatric patients: a systematic review

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