Premium
Pharyngeal morphology: A determinant of successful nasal surgery for sleep apnea
Author(s) -
Morinaga Mami,
Nakata Seiichi,
Yasuma Fumihiko,
Noda Akiko,
Yagi Hidehito,
Tagaya Mitsuhiko,
Sugiura Makoto,
Teranishi Masaaki,
Nakashima Tsutomu
Publication year - 2009
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.20175
Subject(s) - medicine , septoplasty , sleep apnea , anesthesia , polysomnography , apnea , obstructive sleep apnea , hypopnea , surgery , nose
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