[The role of functional nasal surgery in the treatment of obstructive sleep apnea syndrome].

INTRODUCTION

Nasal obstruction is widely mentioned among the factors influencing pathophysiology of obstructed breathing disorders during sleep. However numerous observations confirms such relation, influence of nasal surgery on frequency and intensity of obstructive episodes during sleep remains modest and unpredictable in vast majority of cases. The aim of this study was to evaluate the role of functional nasal surgery in the treatment of Obstructive Sleep Apnea Syndrome (OSAS).

MATERIAL AND METHODS

The study included 83 subjects with OSAS diagnosed by polysomnography and elevated nasal resistance due to different deformities of nasal skeleton. All patients underwent appropriate surgical treatment. Evaluation of day somnolence using Epworth Scale and subjective analysis of snoring and other sleep disturbances using linear scale was carried before and after surgery. Objective results of treatment were assessed by polysomnograpy performed 3 to 4 months after operation.

RESULTS

The results obtained in our group of patients showed a large discrepancy between the subjective estimation of the treatment indicated by the patients and the objective determinations of the polysomnographic test. The average day somnolence intensity was decreased approximately 2 times and 72 (86%) patients stated that snoring intensity as well as other night time symptoms of sleep apnea greatly diminished. Furthermore in the group of 19 patients who continued nCPAP therapy after surgery the side effects of this treatment diminished and lower therapeutic pressure could be provided.

CONCLUSIONS

Correction of nasal obstruction have to be considered in all patients with OSAS because it may help relieve airway obstruction during sleep and improve the general quality of live at least in patients self estimation. Furthermore, an improvement of nasal patency diminishes the side effects of nCPAP therapy and provides lower therapeutic pressure.