Predictive Value of Sleep Nasendoscopy in the Management of Habitual Snorers

Abstract

Sleep nasendoscopy (SN) is claimed to identify the site of obstruction in habitual snoring and is used to select patients for palatal surgery. The validity of SN is, however, unproven. This is the first prospective blind assessment of the role of SN in the management of habitual snorers. Fifty-five consecutive patients listed for laser-assisted uvulopalatoplasty (LAUP) for simple snoring on clinical criteria underwent SN immediately before surgery. Snoring severity and Epworth Sleepiness Scales were completed before the operation and at least 3 months after the operation. The postoperative scores on the snoring severity scale had significantly improved after LAUP, for each SN grade: grade 1 (palatal obstruction; p = .04) and grade 2 (multisegmental obstruction; grade 2A, p = .003, and grade 2B, p = .01). The Epworth Sleepiness Scale showed significant improvement in the whole group (p = .02). We conclude that SN grading of sites of pharyngeal collapse is an insufficient basis to exclude patients from LAUP. Sleep nasendoscopy is thus not of value in the management of habitual snoring, as the measure is a poor predictor of favorable outcome after palatal surgery.

Acoustic parameters of snoring sound to compare natural snores with snores during ‘steady‐state’ propofol sedation

“…Following Pringle and Crofts paper 2 describing the technique of sedation endoscopy, interest in its effectiveness as a predictor of the outcome of snoring surgery grew, with many otolaryngologists in the UK incorporating it into their pre‐operative assessment of snorers. Although subsequent studies were published confirming the original claims that sleep nasendoscopy was able to directly visualize vibrating structures, whilst the patient was sedated, 3,7,8,13 few directly assessed its effectiveness as a predictor of surgical outcome 3,13,14 . Whether sedation‐induced snores bear any resemblance to natural, sleep‐induced snores has yet to be investigated.…”

Effectiveness and Side Effects of One-Stage Laser-Assisted Uvuloplasty in Primary Rhonchopathy

“…Neither the importance of snoring nor the fact whether the patient decided for the operation himself or on the insistence of his bed partner played a role in our series. The use of sleep nasendoscopy to select patients for LAUP [14] did not bring valuable results either. However, several factors can be of importance in the prediction of the effect of LAUP.…”

Funktionelle Topodiagnostik der oberen Atemwege bei schlafbezogenen Atmungsstörungen

“…Hingegen können Counter und Badawey et al diese Vorteile in ihren Untersuchungen nicht bestätigen [7,11].…”