The Effect of Nasal Obstruction on Outcomes of Uvulopalatopharyngoplasty

Abstract

Nasal obstruction is considered an aggravating factor in some patients with obstructive sleep disorders. There are no previous reports about the effect of nasal obstruction on outcomes of uvulopalatopharyngoplasty (UPPP). The symptoms of 100 patients treated by UPPP in our hospital were analysed. Forty-nine of them were diagnosed as having obstructive sleep apnea syndrome (OSAS), as ODI 4 was >5. Nasal obstruction was measured using preoperative anterior active rhinomanometry. The degree of snoring and daytime sleepiness was evaluated using a questionnaire preoperatively and again 6–12 months after the operation. Snoring was relieved in 96% of all patients. Excessive daytime sleepiness improved in 87%, which is also consistent with earlier good results. There was no significant difference in improvement of these symptoms in nonapneic snorers and in patients with OSAS. In the group of 10 patients with highest nasal airway resistance snoring was relieved in only 78% as compared with 98% in the others (p < 0.05). Also excessive daytime sleepiness was better relieved in the group of patent nasal airway, but this difference was not statistically significant. Nasal obstruction can effect the outcome of UPPP. Treatment of nasal obstruction should be considered in chronic snoring if snoring and excessive daytime sleepiness persist after UPPP.

Key Words:

• nasal resistance
• outcome of surgery
• uvulopalatopharyngoplasty
• questionnaire
• rhinomanometry
• sleep recording