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Pharyngeal morphology: A determinant of successful nasal surgery for sleep apnea

✍ Scribed by Mami Morinaga; Seiichi Nakata; Fumihiko Yasuma; Akiko Noda; Hidehito Yagi; Mitsuhiko Tagaya; Makoto Sugiura; Masaaki Teranishi; Tsutomu Nakashima


Book ID
102446998
Publisher
John Wiley and Sons
Year
2009
Tongue
English
Weight
202 KB
Volume
119
Category
Article
ISSN
0023-852X

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✦ Synopsis


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. Laryngoscope, 2009


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