Polysomnographic effects of nasal surgery for snoring and obstructive sleep apnea
Polysomnographic effects of nasal surgery for snoring and obstructive sleep apnea
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DOI：
10.1080/00016480410016252
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发表时间：
2004-03-01
影响因子：
1.4
通讯作者：
Chung, YS
中科院分区：
文献类型：
--
作者：
Kim, ST;Choi, JH;Chung, YS
目的 - 据推测，鼻塞会导致上呼吸道负压增加，并导致咽部吸气塌陷。我们使用便携式多导睡眠监测仪 (PSG) 来评估鼻部手术治疗打鼾和阻塞性睡眠呼吸暂停 (OSA) 的效果。材料和方法 - 我们回顾了 21 名出现鼻塞和打鼾的患者。进行了伴有或不伴有下鼻甲切除术的间隔手术。每位患者在术前和术后均使用 PSG 进行评估。我们测量了呼吸窘迫指数（RDI）、呼吸暂停指数（AI）、氧饱和指数（OSI）和打鼾持续时间。选择标准是 PSG 确定的 RDI > 15，以及体检确定的临床鼻塞和鼻中隔偏曲。结果 - 鼻部手术具有以下效果：RDI 从 39 下降至 29 (p = 0.0001)，AI 从 19 下降至 16 (p = 0.0209)，OSI 从 48 下降至 32 (p = 0.0001)，并且鼻部手术的持续时间打鼾从 44% 下降到 39% (p = 0.1595)。 4 名患者 (19%) 的打鼾和 OSA 完全缓解，不需要任何额外的手术治疗。结论 - 某些患者仅通过鼻中隔手术即可纠正打鼾和 OSA，通过术后 PSG 进行彻底评估后，可以考虑二次手术（悬雍垂腭成形术）。
Objective - It has been hypothesized that nasal obstruction causes an increase in negative pressure in the upper airway and induces an inspiratory collapse at the pharyngeal level. We used portable polysomnography (PSG) to assess the efficacy of nasal surgery for snoring and obstructive sleep apnea (OSA).Material and Methods - We reviewed 21 patients who presented with nasal obstruction and snoring. Septal surgery with or without inferior turbinectomy was performed. Each patient was assessed pre- and postoperatively using PSG. We measured the respiratory distress index (RDI), apnea index ( AI), oxygen saturation index (OSI) and the duration of snoring. Selection criteria were an RDI of >15 as determined by PSG and clinical nasal obstruction and a deviated nasal septum as determined by physical examination.Results - Nasal surgery had the following effects: RDI decreased from 39 to 29 (p = 0.0001), AI decreased from 19 to 16 (p = 0.0209), OSI decreased from 48 to 32 (p = 0.0001) and the duration of snoring decreased from 44% to 39% (p = 0.1595). Snoring and OSA were completely relieved in 4 patients (19%) who did not require any additional surgical therapy.Conclusion - Snoring and OSA may be corrected merely by septal surgery in some patients, and secondary surgery (uvulopalatoplasty) may be considered after a thorough evaluation by means of postoperative PSG.