Sleep Apnea Syndromes: Cozza P

Villa MP, Brunetti L, Bruni O, Cirignotta F, Cozza P, Donzelli G, Ferini Strambi L, Levrini L, Mondini S, Nespoli L, Nosetti L, Pagani J, Zucconi M, Anonymous00069. · Gruppo di Studio interdisciplinare disturbi respiratori nel sonno, Società Italiana di Pediatria, Rome, Italy. · Minerva Pediatr. · Pubmed #15252374 links to  free full text

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Cozza P, Ballanti F, Castellano M, Fanucci E. · Department of Orthodontics, University of Rome Tor Vergata. · Prog Orthod. · Pubmed #19294236 No free full text.

Abstract: OBJECTIVE: The aim of this study was to investigate pharyngeal size differences between pre- and posttrials of a Mandibular Advancement Device (MAD), using a computed tomography (CT),in the treatment of Obstructive Sleep Apnea (OSA) adult patients. MATERIALS AND METHODS: Eighteen patients with mild to moderate OSA (mean Apnea/Hypopnea Index, AHI, of 16.7) were treated with a MAD to wear at night only. After 3 months of treatment, three-dimensional changes in pharyngeal dimensions were measured on CT images performed with a sixteen detector-row CT scanner (Light Speed Plus; GE Medical Systems). Two consecutive axial sections from the hard palate to the epiglottis were obtained with and without the appliance. Measurements were made of the following airway areas (mm2) and lengths (mm): RF (nasopharynx); ROF (naso-oropharynx); OF (oropharynx); IPF (hypopharynx); SPL (soft palate length); SPT (soft palate thickness); Rgn (retrognation)-hyoid bone; hyoid bone-C2; Rgn-C2; PhL (oropharynx length); pharynx posterior wall thickness at three level. The angle between the hard and the soft palate (APDM) was also calculated. RESULTS: AHI improved significantly (from 16.7 to 11.2) when the appliance was used. Measurements from CT scans showed statistically significant expansion in the naso-oropharynx area (RF p<.014; ROF p<.050), in the Rgn-C2 length (p<.005) and in the angle between the hard and the soft palate (APDM p<.001). CONCLUSIONS: Our findings confirm the effectiveness of MAD in the treatment of patients with mild to moderate OSA. The use of MAD significantly expands the areas of the upper airway lumen most involved in the collapse.

Cozza P, Polimeni A, Ballanti F. · Department of Orthodontics, University of Rome 'Tor Vergata', Italy. · Eur J Orthod. · Pubmed #15536841 links to  free full text

Abstract: The aims of this study were to determine the differences in craniofacial morphology between children with obstructive sleep apnoea (OSA) and control subjects, and to investigate the effects of modified monobloc (MM) appliance treatment in OSA children. The treatment group consisted of 20 OSA Caucasian subjects (10 boys and 10 girls) with ages ranging from 4 to 8 years (mean 5.91 years). The control group comprised 20 healthy Caucasian subjects without OSA (10 boys and 10 girls) with ages ranging from 5 to 7 years (mean 6 years). Polysomnography was used to establish the diagnosis of OSA and to evaluate the effects of MM treatment in the test group. Cephalometric radiographs and study models were obtained for all subjects. A number of statistically significant differences were detected in craniofacial morphology between the treatment group and controls. The treatment group demonstrated a skeletal Class II pattern (P= 0.04), with a reduced mandibular length (P= 0.03) and a corresponding increase in overbite. The hyoid bone was located superiorly in the OSA group (P = 0.04). Analysis of the dental arches demonstrated a significantly smaller distance between the first and second inter-molar primary mandibular regions (P = 0.03 and P = 0.04, respectively) in OSA patients. Repeat polysomnography, with the MM in situ, after 6 months of wear, revealed a significant reduction in the apnoea-hypopnoea index in children with OSA (P= 0.0003). The MM was found to reduce daytime sleepiness and to subjectively improve assessed sleep quality. The patients and their parents reported good compliance with MM treatment.

Cozza P, Ballanti F, Prete L. · University of Rome Tor Vergata; via Veio, 53, Rome, Italy. · J Clin Orthod. · Pubmed #15115898 No free full text.

This publication has no abstract.

Cozza P, Gatto R, Ballanti F, Prete L. · Department of Orthodontics, University of Rome Tor Vergata, Italy. · Eur J Paediatr Dent. · Pubmed #15038786 No free full text.

Abstract: AIM: This was to investigate the effect of the use of an orthodontic appliance in the treatment of obstructive sleep apnoea (OSA) in children using polysomnographic variables. METHODS: 10 boys and 10 girls with OSA aged between 4 to 8 years, referred from an otolaryngology clinic because of sleep apnoea, wore modified monobloc devices nightly for 6 months. Polysomnography was used for each patient for baseline diagnosis of OSA and also for post therapy assessment. RESULTS: The median obstructive apnoea- hypopnoea index decreased after 6 months of therapy with oral appliances. The mean (+/-SD) number of episodes of OSA was 7.88+/-1.81 before treatment and 3.66+/-6.80 after 6 months (p<0.001). CONCLUSIONS: The modified monobloc appliance is suggested for use in children with OSA and may be an effective therapeutic alternative in children with mild to moderate OSA.