CLINICAL STUDY OF NASAL SURGERY IN OBSTRUCTIVE SLEEP APNEA AND SLEEP DISORDERED BREATHING
Aim: Objective study of the effect of nasal surgery alone may provide us new and improved information about seriousness of nasal obstruction in OSA and SDB. the result of this study may help us in improving approach to the treatment of OSA and SDB.
Materials and Methods: 80 patients who attended ENT OPD and get operated in the ENT department of RKDF MC&RC, Bhopal in the study period of two years were selected for clinical study of nasal surgery in obstructive sleep apnea and sleep disordered breathing. Detailed clinical history was taken from patients and their attendant (spouse and family member). Thorough clinical examination was carried out on all the patients with the help of head light, nasal speculum, endoscopes and radiological like X-ray evaluation and CT scan.
Results: Before surgery, all 80 patients reported nasal airway obstruction and snoring. Seventy-seven of them reported improvement in day time somnolence and reduction in decreased daytime energy. After surgery, all 80 patients reported improved nasal breathing. 65 patients reported reduced day time somnolence, 12 patients reported minimal or no improvement, 3 patients reported worsening of symptom. 30 patients noticed reduced/decreased snoring while 40 patients were not aware of improvement, 10 patients reported that snoring completely resolved after surgery.65 patients quoted improvement in early morning headache, while 15 patients doesn’t notice any change.30 patients noticed improvement in personality and mental frame-upConclusion: Lot more is required to be done in surgical treatment of OSA and SDB by the otorhino-laryngologist. As the cause of OSA and SDB is multiple leveled in etiology, nasal surgery alone is not likely to correct OSA and SDB. The patients undergoing nasal surgery in the treatment of OSA SDB should understand that it is a part/portion of a comprehensive management plan. This study establishes the fact that nasal surgery plays indispensable role in the treatment of OSA and SDB.
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