We evaluated the outcomes of nasal surgery for sleep-disordered breathing, including obstructive sleep apnea syndrome (OSAS), respiratory effort-related arousal, and snoring. To reduce pharyngeal negative pressure during sleep, the nasal parasympathetic nerve was resected, and the nasal cavity was enlarged by submucosal inferior turbinectomy and septoplasty if necessary. Of the 45 severe OSAS patients, symptoms were significantly ameliorated in 67%. This low-invasiveness nasal operation effectively reduced excessive daytime sleepiness and bothersome snoring without any pharyngeal operation. In addition, no side effects have been reported to be associated with this treatment regimen.
Objectives and Methods: Twenty four severe obstructive sleep apnea syndrome (OSAS) patients, 35 sleep disordered breathing (SDB) patients with excessive daytime sleepiness, and 74 simple snorers underwent coblation-assisted uvulopalatopharyngoplasty (cobUPPP) under local anesthesia. Polysomnography (PSG) events, snoring, QOL (SF-36 v2) and excessive daytime sleepiness on the Epworth sleepiness scale (ESS) were assessed 3 months after the operation. The overall assessment criteria of the operative effectiveness on OSAS were proposed using subjective symptoms and PSG events. Informed consent was obtained in writing from all participants prior to cobUPPP. Results: AI (P<0.0001), AHI (P<0.0001), ODI (P<0.0001), minimum SpO 2 (P=0.028), SpO 2 <90% (P=0.008) and the arousal index (P=0.001) were significantly ameliorated. Excessive daytime sleepiness was ameliorated in 34/35 cases and bothering snoring was improved, based on visual analog scale scoring, in 54/55 cases. Treatment of OSAS was assessed as highly effective in 11/24, 9/24 effective and 4/24 ineffective. Transient discomfort of the pharynx was an occasional complaint. Conclusion: cobUPPP was effective for severe OSAS without significant complications and could be very useful to manage excessive daytime sleepiness and socially unacceptable snoring.
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