Pharyngeal morphology: a determinant of successful nasal surgery for sleep apnea.

Abstract

OBJECTIVES/HYPOTHESIS:

To estimate the effectiveness of nasal surgery on the occurrence of sleep apnea, and to analyze the pharyngeal morphology of apnea patients whose sleep-disordered breathing was ameliorated postoperatively.

STUDY DESIGN:

Prospective study.

METHODS:

Thirty-five consecutive patients with apnea and nasal obstruction underwent polysomnography and a morphological examination of the upper airway before and after nasal surgery, which included septoplasty, inferior turbinectomy, and/or functional endoscopic sinus surgery.

RESULTS:

Sleep apnea was significantly ameliorated in only eight patients. The postoperative reduction in the apnea-hypopnea index tended to be lower in those with a low-positioned soft palate, reflected in an elevated modified Mallampati score, and a narrow retroglossal space. Neither swollen tonsils nor narrow fauces affected the surgical outcome. Regression analysis showed that the modified Mallampati score (P < .05) and the retroglossal space (P < .05) were significant predictors of postoperative improvement in the apnea-hypopnea index.

CONCLUSIONS:

Among sleep apnea patients suffering from nasal obstruction, nasal surgery is effective in those with a high-positioned soft palate and/or a wide retroglossal space.

• Authors: Mami Morinaga, Seiichi Nakata, Fumihiko Yasuma, Akiko Noda, Hidehito Yagi, Mitsuhiko Tagaya, Makoto Sugiura, Masaaki Teranishi, Tsutomu Nakashima
• Journal: The Laryngoscope (Laryngoscope) Vol. 119 Issue 5 Pg. 1011-6 (May 2009) ISSN: 1531-4995 [Electronic] United States
• PMID: 19301414 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Female
• Humans
• Male
• Middle Aged
• Nasal Obstruction (surgery)
• Pharynx (anatomy & histology)
• Polysomnography
• Prospective Studies
• Sleep Apnea Syndromes (surgery)
• Treatment Outcome