The Effects of Septal Surgery for Snoring and Obstructive Sleep Apnea (OSA) on Polysomnography (PSG)

Chung, Yoo Sam; Hwang, Soo Hoon; Kim, Sun Tae; Park, Jung Soo; Cha, Heung Eog; Kim, Dong Young

Abstract

BACKGROUND AND OBJECTIVES: Nasal obstruction is common in patients with snoring and obstructive sleep apnea (OSA). A hypothesis has been reported that nasal obstruction causes more negative pressure in the upper airway and induces an inspiratory collapse at the pharyngeal level. We tried to assess the efficacy of the septal surgery on snoring and OSA by using portable polysomnography (PSG). MATERIALS AND METHOD: We reviewed 21 patients who had nasal obstruction and snoring. Septal surgery was performed. Each patient was assessed by pre and postoperative PSG. We measured respiratory distress index (RDI), apnea index (AI), oxygen saturation index (OSI) and the duration of the snoring. Selection criteriae were a RDI over 15 on the PSG, clinical nasal obstruction and deviated nasal septum by examination.
RESULTS
After septal surgery, 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). The duration of the snoring decreased from 44% to 39% (p=0.1595). Snoring and OSA were completely relieved in 4 patients (19%) who didn't need any additional surgical therapy.
CONCLUSION
Snoring and OSA can be corrected merely by the septal correction in some patient. And secondary surgery (uvulopalatoplasty) should be considered after thorough evaluation of postoperative PSG.