Evaluation of Endonasal Rhinoplasty for Sleep-Disordered Breathings due to Nasal Resistance

概要

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In fifty-six patients with sleep-disordered breathing (SDB), including obstructive sleep apnea-hypopnea syndrome (OSAHS), upper airway resistace syndrome (UARS), snoring and excessive daytime sleepiness, the nasal resistance was measured preoperatively with rhinomanometry using the anterior method. All 56 patients (ages ranging from 21 to 73, 48 men and 8 women), underwent endonasal rhinoplasty (ER) consisting of a septoplasty and bilateral submucosal inferior turbinectomy with posterior nasal nerve resection, and bilateral partial middle turbinectomy. Three months later, the postoperative effect of the ER was evaluated using polisomnography with or without electroencephalography, the Epworth sleepiness scale (ESS) and rhinomanometry. In cases with both bilateral or ipsilateral nasal resistance over 0.35 Pa/cm3/s ER was highly effective in alleviating OSAHS, UARS, excessive daytime sleepiness and improvement of respiratory events during sleep. The high effectiveness of ER for SDB suggests increased nasal resistance during sleep greatly affects the pathophysiology of SDB.