Objective. To assess the clinical parameters for successful uvulopalatopharyngoplasty in the management of obstructive sleep apnoea syndrome documented with pre- and postoperative polysomnography. Materials and Methods. A study group of 50 patients diagnosed as having OSA by full night polysomnography were assessed clinically and staged on basis of Friedman staging system. BMI and neck circumference were considered, and videoendoscopy with Muller's maneuver was done in all to document the site of obstruction. The study group divided into surgical and nonsurgical ones. Twenty-two patients out of fifty were then selected for uvulopalatopharyngoplasty. The selection of surgical group was done primarily on basis of clinical parameters like neck circumference, Friedman stage of the patient and site, and/or level of obstruction of patient. Postoperative polysomnography was done six months after surgery to document the change in AHI score. Result. The study group consists of fifty patients with mean age of 44.4 ± 9.3 years. UPPP was done in twenty-two, and the result of the surgery as defined by 50% reduction in preoperative AHI with postoperative AHI < 20/h was seen to be 95.2%. Postoperative change in AHI done after 6-month interval was seen to be statistically significant with P value < 0.001. Conclusion. UPPP is ideal option for management of obstructive sleep apnoea syndrome in properly selected patients on the basis of Friedman stage and site of obstruction detected by videoendoscopy with Muller's maneuver.
Introduction: Snoring is ''to breathe during sleep with harsh, snorting noises caused by vibration of the soft palate''. Naturally occurring or drug-induced sleep is a requirement for its appearance. Snoring is the audible sign of increased upper airway resistance. It is known to be an important clinical hallmark of OSA (Nakano et al., 2003) and, as such, may be a useful and an easily accessible marker to screen for obstructive SDB.Materials and methods: This study was conducted in the Department of Otorhinolaryngology Head and Neck Surgery, Government Medical College, Srinagar and includes 37 patients who presented in our OPD themselves with complaints of snoring or are referred from some other speciality or institution. After thorough history taking and examination all patients were evaluated with Muller's maneuver, overnight polysomnography and intensity of snoring sound were measured with the help of sound level meter. All patients with Muller's maneuver documented soft palatal obstruction and PSG documented snoring were distributed into two treatment groups 17 patients in the Z palatoplasty group and 20 patients in the UP3 group depending on the grade of tonsillar hypertrophy.Results: This study showed that there was a statistically significant (P < 0.05) improvement in the percentage of snoring and intensity of snoring after 3 weeks, 3 months and 6 months of treatment in both Z palatoplasty and UP3 groups of patients.Conclusion: This study showed that Z palatoplasty and UP3 are best treatment options for patients with palatal snoring without tonsillar hypertrophy and with tonsillar hypertrophy respectively.
Introduction: Snoring is the production of sound by the upper aero digestive tract during sleep. Snoring is commonly regarded as a laughable circumstance or a source of irritation to the observer, about which little can be done but to awaken the unwitting culprit habitual loud snoring may be socially unacceptable, and may constitute a reason for sleeping apart, marital disharmony, divorce, aggression and homicide. There are various treatments for snoring, both medical and surgical depending upon severity of snoring and site of snoring sound production. Aim of this study was to compare three surgical treatments for palatal snoring done under local anesthesia, sling Snorplasty, modified sling snorplasty and injection snorplasty. Material and method: This study was conducted in the department of Otorhinolaryngology Head and Neck Surgery, Government Medical College Srinagar and includes 48 patients who presented in our OPD with complaints of snoring or are referred from some other specialty or institution for the complaints of snoring. After thorough history and examination, all patients were evaluated with Mullers maneuver, overnight polysomnography and intensity of snoring sound measured with the help of sound level meter. All patients with Mullers maneuver documented soft palatal obstruction and PSG documented simple snoring were randomly distributed using random number table into three different treatment groups, Sling Snorplasty, modified Sling Snorplasty and injection Snorplasty. Results: This study showed that there were Statistically significant (P<0.05) improvement in percentage of snoring and intensity of snoring after 3 weeks, 3 months and 6 months of treatment in sling snorplasty and modified sling snorplasty treatment groups. Patients in injection snorplasty treatment group showed improvement in percentage of snoring and intensity of snoring after 3 weeks of treatment but that improvement was not statistically significant (P>0.05) and no improvement was seen after 3 months and 6 months of treatment. Conclusion: The present study suggested that modified sling snorplasty and sling snorplasty are day care procedures of choice for treatment of simple palatal snoring and should be offered to all patients with simple palatal snoring.
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