Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance

Virkkula, Paula; Bachour, Adel; Hytönen, Maija; Salmi, Tapani; Malmberg, Henrik; Hurmerinta, Kirsti; Maasilta, Paula

doi:10.1378/chest.129.1.81

Cited by 79 publications

(70 citation statements)

References 40 publications

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“…Virkkula et al in their study observed that operative treatment of mainly structural nasal obstruction did not seem to decrease snoring intensity, snoring time, or sleep-disordered breathing. 13 In contrast to this study, studies by Kim et al and Nakata et al while assessing a different ethnic group showed a significant improvement in sleep parameters. 14,15 In our study all 10 patients who had hyposmia were managed with endoscopic septoplasty as they also had other pathologies for which FESS was done.…”

Section: Discussioncontrasting

confidence: 96%

Septoplasty techniques- conventional versus endoscopic: our experience

Rajguru¹,

Singh

Galagali³

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Deviated nasal septum is one of the most common disorders in human beings, which may lead to symptoms of nasal obstruction, headache, epistaxis, hyposmia, and post nasal drip. DNS correction may also be required to gain access during intranasal procedures like endoscopic sinus surgery, endoscopic dacryocystor-hinostomy and skull base surgery. The technique of septoplasty has evolved over the decades with a tendency towards more conservative and precise surgery. Over the last few decades endoscopic septoplasty has become increasingly popular.Methods: It was a cross-sectional comparative study done to compare the efficacy of endoscopic septoplasty with conventional septoplasty, conducted at a tertiary care centre over a period of 3 years. Records of 100 patients of nose and PNS disorders with DNS who were operated either by conventional or by endoscopic technique were studied. The patients were studied for the improvement in their symptoms, anatomical correction and intra-operative/post-operative complications. Results: Endoscopic septoplasty group patients showed better symptomatic relief, lesser incidence of residual anterior /posterior deviation and persistent spur and less complications as compared to the conventional septoplasty group.Conclusions: In our study we found more clientele satisfaction and lesser rate of complications in endoscopic septoplasty group. We recommend all ENT specialists to be trained in nasal endoscopic septoplasty technique as it offers many advantages such as more precision in post nasal spurs with less flap tears, it can be tailor made according to the disease and can be combined with various endoscopic surgeries.

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Section: Discussioncontrasting

confidence: 96%

Septoplasty techniques- conventional versus endoscopic: our experience

Rajguru¹,

Singh

Galagali³

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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“…These findings suggest that the ability to switch from oral to nasal breathing when nasal airflow resistance is lowered represents an important determinant of a positive outcome of nasal surgery. Similar negative findings have been reported by three other nonrandomised studies, which included consecutive patient selection and objective assessment of SDB variables before and after surgery [47][48][49]. However, SERIES et al [50] reported significant improvements in AHI following surgical relief of nasal obstruction in a group of mild OSAS patients who had normal pre-operative cephalometry.…”

Section: Impact On Sdb Severity Of Medical or Surgical Management To supporting

confidence: 74%

The nose and OSA: variable nasal obstruction may be more important in pathophysiology than fixed obstruction

McNicholas¹

2008

European Respiratory Journal

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“…In the same study, continuous positive airway pressure (CPAP) pressure levels required to correct OSA decreased significantly after nasal surgery. However, in a recently published observational, uncontrolled, prospective study including 40 snoring males, operative treatment of nasal obstruction decreased NR but did not improve snoring, nocturnal breathing or sleep architecture [48].…”

Section: Clinical Considerationsmentioning

confidence: 85%

“…The potential effects of surgical treatment of chronic nasal obstruction on snoring and OSA have been investigated in various nonrandomised, uncontrolled trials [48][49][50][51][52][53]. In an early study, DAYAL and PHILLIPSON [51] investigated the effect of nasal valve correction on snoring and OSA in six patients, and found significant improvement in snoring and apnoea/ hypopnoea index (AHI) post-operatively.…”

Section: Clinical Considerationsmentioning

confidence: 99%

The role of the nose in the pathogenesis of obstructive sleep apnoea and snoring

Kohler¹,

Bloch²,

Stradling³

2007

European Respiratory Journal

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Data from observational studies suggest that nasal obstruction contributes to the pathogenesis of snoring and obstructive sleep apnoea (OSA). To define more accurately the relationship between snoring, OSA and nasal obstruction, the current authors have summarised the literature on epidemiological and physiological studies, and performed a systematic review of randomised controlled trials in which the effects of treating nasal obstruction on snoring and OSA were investigated.Searches of bibliographical databases revealed nine trials with randomised controlled design. External nasal dilators were used in five studies, topically applied steroids in one, nasal decongestants in two, and surgical treatment in one study.Data from studies using nasal dilators, intranasal steroids and decongestants to relieve nasal congestion showed beneficial effects on sleep architecture, but only minor improvement of OSA symptoms or severity. Snoring seemed to be reduced by nasal dilators. Nasal surgery also had minimal impact on OSA symptoms.In conclusion, chronic nasal obstruction seems to play a minor role in the pathogenesis of obstructive sleep apnoea, and seems to be of some relevance in the origin of snoring. The impact of treating nasal obstruction in patients with snoring and obstructive sleep apnoea on long-term outcome remains to be defined through randomised controlled trials of medical and surgical therapies.

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Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance

Cited by 79 publications

References 40 publications

Septoplasty techniques- conventional versus endoscopic: our experience

Septoplasty techniques- conventional versus endoscopic: our experience

The nose and OSA: variable nasal obstruction may be more important in pathophysiology than fixed obstruction

The role of the nose in the pathogenesis of obstructive sleep apnoea and snoring

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