The effect of surgical correction of pathological changes in the nasal cavity on the severity of obstructive sleep apnea syndrome in patients undergoing laser sculptural uvulopalatoplasty



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Background. Nasal obstruction plays an important role in the pathogenesis of ronchopathy. Narrowing of the nasal cavity, in the presence of certain pathological changes in it, leads to an increase in resistance to the inhaled air flow. However, surgical correction of these changes in patients with ronchopathy and obstructive sleep apnea syndrome does not necessarily lead to a decrease in pharyngeal obstruction, and the absence of changes in the severity of obstructive sleep apnea syndrome after surgical removal of nasal obstruction shows the ineffectiveness of surgical treatment.

Aim. To evaluate the effect of surgical correction of pathological changes in the nasal cavity on the degree of reduction of the severity of obstructive sleep apnea syndrome in patients undergoing laser sculptural uvulopalatoplasty.

Methods. The data of the analysis of the results of anterior active rhinomanometry and their correlation with the data of monitoring computer pulse oximetry and polysomnography in 72 patients with ronchopathy and obstructive sleep apnea syndrome aged 37 to 75 years who underwent laser sculptural uvulopalatoplasty are presented.

Results. The study showed that despite the positive effect of surgical interventions in eliminating nasal obstruction, confirmed by the results of anterior active rhinomanometry, the subjective improvement in sleep quality and general somatic condition in the vast majority of operated patients (45 out of 52 or 86.5%) - a decrease in the severity of obstructive sleep apnea syndrome after laser sculptural uvulopalatoplasty is objectively confirmed by the results of computer monitoring Pulse oximetry and polysomnography were performed in only 18 (34.6%) of 52 operated patients with various degrees of syndrome.

Conclusion. Surgical correction of pathological changes in the nasal cavity reduces the severity of obstructive sleep apnea syndrome in patients who underwent laser sculptural uvulopalatoplasty in only 34.6% of cases.

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作者简介

Vladimir Knyazkov

Russian University of Medicine of the Ministry of Health of the Russian Federation

编辑信件的主要联系方式.
Email: v.b.knyazkov@mail.ru
ORCID iD: 0000-0001-5742-3459
SPIN 代码: 9303-5321

кандидат медицинских наук, младший научный сотрудник лаборатории минимально инвазивной хирургии НИИ ТЕХНОБИОМЕД НОИ медицинских технологий им. С.Н. Федорова

俄罗斯联邦

参考

  1. Lavie P. et al. Excessive daytime sleepiness and insomnia. Association with deviated nasal septum and nocturnal breathing disorders / P. Lavie, J. Zomer, I. Eliaschar, Z. Joachim, E. Halpern, A. H. E. Rubin, G. J. Alroy // Arch. Otolaryngol. 1982. 108:373-377.
  2. Heimer D. et al. Sleep apnoea syndrome treated by repair of deviated nasal septum / D. Heimer, S. Scharf, A. Lieberman // Chest. 1983. 84:184-185.
  3. Petruson B. Snoring can be reduced when the nasal airflow is increased by the nasal dilator Nozovent / B. Petruson // Arch. Otolaryngol. Head Neck Surg. 1990. 116:462-464.
  4. Lopatin A.S. i soavt. Khrap i sindrom obstruktivnogo apnoeh vo sne / A.S. Lopatin, R.V. Buzunov, A.M. Smushko, N.EH. Doroshenko, V.A. Eroshina // Rossijskaya rinologiya. 1998. № 4, – S. 17-33.]
  5. Nikolaeva, I. V. Ronkhopatiya (klinika, diagnostika, lechenie): avtoref. dis. … kand. med. nauk: 14.00.04. / Nikolaeva Irina Vital'evna – M, 1997. – 23 s.]
  6. Lofaso F. Nasal obstruction as a risk factor for sleep apnea syndrome // Respir. Jurn. 2000. Vol. 16. P. 639–643.
  7. Sheludchenko, T. P. Rol' giperplazii limfoidnogo kol'ca glotki v patogeneze sindroma obstruktivnogo apnoeh sna / T. P. 7. Sheludchenko, A. S. Lopatin, P. A. Kochetkov // Rossijskaya otorinolaringologiya. – 2002. - № 2. – S. 119-120.]
  8. Zelveyan P. A., Oshchepkova E. V., Arabidze G. G. Sleep apnea syndrome and arterial hypertension. Ter. Arkhiv; 1997; 9: 76-80 (in Russian).
  9. Marshall N. S. et al. Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study // Sleep. 2008. № 31. P. 1079-1085.
  10. Chandra R. K., Patadia M. O., Raviv J. Diagnosis of nasal airway obstruction // Otolaryngol. Clin. North. Am. 2009. № 42. P. 207-225.
  11. Ul'yanov, YU. P. Mestnye prichiny i sledstviya khrapa / YU. P. Ul'yanov // Mezhdunarodnyj medicinskij zhurnal. – 1999. - № 1-2, – S. 108-111.]
  12. Ilium P. Septal deviation in snoring patients evaluated by acustic rhinometry / P. Ilium // 15th European Rhinologic Congress, 13th ISLAN. Abstract Book. Copengagen. 1994. – Р. 125.
  13. Miljeteig H. et al. The effect of unilateral and bilateral nasal obstruction on snoring and sleep apnoea / H. Miljeteig, V. Hoffstein, P. Cole // Laryngoscope. 1992. 102:1150-1152.
  14. Miljeteig H. et al. Snoring and nasal resistance during sleep / H. Miljeteig, P. Savard, S. Mateika, P. Cole, J. Haight, V. Hoffstein // Laryngoscope. 1993. 103:918-923.
  15. Piche J. et al. Snoring, apnea and nasal resistans / J. Piche, N. B. Gagnon // J Otolaryngol. 1996 Jun; 25(3): 150-154 PMID: 8783078
  16. Welinder R. et al. Reduced nasal airway resistans following uvulopalatoplasty / R. Welinder, L. O. Cardell, R. Uddman, L. Malm // Rhinology. 1997; 35(1):16-18 PMID: 9200257
  17. Li H. Y. et al. Improvement in Quality of Life After Nasal Surgery Alone for Patients With Obstructive Sleep Apnea and Nasal Obstruction / H. Y. Li, Y. Lin, N. H. Chen, L. A. Lee, T. J. Fang, P. C. Wang // Arch. Otolaryngol. Head Neck Surg. – 2008. – Vol. 134, No 4. – P. 429-433 PMID: 18427011 doi: 10.1001/archotol.134.4.429
  18. Sériès F. et al. Effects of surgical correction of nasal obstruction in the treatment of obstructive sleep apnoea / F. Sériès, S. S. T. Pierre, G. Carrier // 1992. Am. Rev. Respir. Dis. 146: 1261-1265.
  19. Sufioğlu M. et al. The efficacy of nasal surgery in obstructive sleep apnea syndrome: a prospective clinical study / M. Sufioğlu, O. A. Ozmen, F. Kasapoglu, U. L. Demir, A. Ursavas, L. Erişen, S. Onart // Eur Arch Otorhinolaryngol. – 2012. – Vol. 269, No 2. – P. 487-494 PMID: 21761192 DOI: 10.1007 / s00405-011-1682- z
  20. Metes A. et al. Snoring, apnea and nasal resistance in men and women / A. Metes, M. Ohki, P. Cole, J. S. Haight, V. Hoffstein // J. Otolaryngol., 1991, Feb;20(1):57-61. PMID: 2030540
  21. Virkkula P. et al. Snoring is not relieved by nasal surgery despite improvement in nasal resistance / P. Virkkula, A. Bachour, M. Hytönen, T. Salmi, H. Malmberg, K. Hurmerinta, P. Maasilta // Chest. – 2006. – Vol. 129, No 1. – P. 81-87 PMID: 16424416 doi: 10.1378/chest.129.1.81
  22. Reshetnikov S. V. Klinicheskaya znachimost' nosovoj obstrukcii u pacientov s sindromom obstruktivnogo apnoeh sna: avtoref. dis. … kand. med. nauk: 14.00.04. / Reshetnikov Sergej Vladimirovich. – M. 2011. – 26 s.
  23. Tardov M.V., Kunelskaya N.L., Turovsky A.B., Ivoylov A.Y., Klyasov A.V., Zarapkin G.Y., Artemev M.E., Arhangelskaya I.I., Zaoeva Z.O., Kondrashina V.V. Influence of rhinosurgery on the course of obstructive apnea syndrome // I.P. Pavlov Russian Medical Biological Herald. - 2015. - Vol. 23. - N. 3. - P. 106-110. (In Russ.)] doi: 10.17816/PAVLOVJ20153106-110
  24. Kawano K. et al. Changes in nasal and oral respiratory resistance before and after uvulopalatopharyngoplasty / K. Kawano, N. Usui, H. Kanazawa, I. Hara // Acta Otolaryngol. Suppl. 1996; 523:236-8. PMID: 9082793.
  25. Shi Y. et al. High nasal resistance may be a result rather than a cause of obstructive sleep apnea / Y. Shi, H. Lou, H. Wang, Y. Zhou, L. Wang, Y. Li, D. Han // Eur. Arch. Otorhinolaryngol. 2014 Nov;271(11):2999-3003. PMID: 24792012 DOI: 10.1007 / s00405-014-3061- z
  26. Welinder R. et al. Reduced nasal airway resistance following uvulopalatoplasty / R. Welinder, L. O. Cardell, R. Uddman, L. Malm // Rhinology. 1997. Mar;35(1):16-8. PMID: 9200257
  27. Knyazkov VB, Prazdnikov EN, Stakhanov ML, Daykhes NA. Laser sculptural uvulopaltoplasty as a new method of surgical treatment of snoring and obstructive apnea syndrome. Russian Journal of Operative Surgery and Clinical Anatomy. 2023;7(1):5-12. (In Russ.) https://doi.org/10.17116/operhirurg202370115
  28. Knyazkov VB, Prazdnikov EN, Stakhanov ML, Daykhes NA. Laser sculptural uvulopaltoplasty as a new method of surgical treatment of snoring and obstructive apnea syndrome. Russian Journal of Operative Surgery and Clinical Anatomy. 2023;7(1):5-12. (In Russ.) https://doi.org/10.17116/operhirurg202370115
  29. Knyazkov V.B., Prazdnikov E.N., Dykhes N.A. Rationale for the feasibility of performing laser sculptural uvulopalatoplasty for patients with rhonchopathy and obstructive sleep apnea syndrome // Laser medicine. 2023. - 27(4): 26-34 (In Russ.) https://doi.org/10.37895/2071-8004-2023-27-4-26-34
  30. Erokhin A. L. Neopredelennost' izmereniya differencial'nogo davleniya pri perednej aktivnoj rinomanometrii // Sistemy obrabotki informacii. 2013. № 3. S. 112–115.
  31. Derzhavina L.L. Morpho-physiological features of the nasal cavity in normal conditions and with its functional disorders according to the methods of anterior active rhinomanometry and acoustic rhinomanometry: abstract. dis…. Ph.D. biol. Sci. Yaroslavl. 2002. 26 p.

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