Splinting vs surgery for carpal tunnel syndrome.
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To clarify the functional mechanism of the Esmarch device in the treatment of sleep apnea, its effect on muscle activity during sleep was studied electromyographically with and without the appliance at the inferior head of the lateral pterygoid muscle, the genioglossal muscle, and the masseter muscle in 15 patients with sleep apnea syndrome. During the obstructive apnea the muscles showed significantly lower amplitudes than before the apnea. No significant decrease in the amplitude was observed during the central apnea, but, after the obstructive and central apnea, significantly higher amplitudes were seen than beforehand. The amplitudes rose after the placement of the appliance, and the amplitudes of the genioglossal and lateral pterygoid muscles during obstructive apnea increased significantly after the insertion of the appliance. The results suggest that the device can activate the masticatory and tongue muscle activity and indicate that the muscles activated with the appliance can prevent obstruction in the oropharynx. The Esmarch device not only helps avoid obstruction by mandibular protraction, but also affects function by activating the muscles.
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