Snoring- evaluation and management
Snoring is the sound produced while sleeping due to vibration of lax of muscles during sleep or any anatomical obstruction in the upper respiratory tract from nose to larynx. It may be the first symptom of obstructive sleep apnea(OSA). It can lead to many problems some of which are shown below.
When a patient comes to us with snoring we calculate body mass index and advise them to undergo polysomnography to grade the disease.
If apnea hypoapnea index is high in sleep study.
We advise them to have sleep endoscopy (DISE: Drug induced sleep endoscopy) under sedation as this will mimic sleep and we will know exact obstruction region or extent of collapse in airway.
Based on all the above tests we can conclude whether patient needs surgery or not.
If there is no anatomical obstruction we advise them to reduce weight / life style modification.
If there is anatomical obstruction (most cases) -like deviated nasal septum, hypertrophied inferior turbinate, nasal polyps, adenoids, elongated uvula, bulky soft palate,hypertrophied tonsils, large tongue base and epiglottic collapse.
we advise different types of surgery based on the level of obstruction taking help of coblation technology.
preop photo. Above photo shows surgical area with blue marking and one of the coblation wands which we use for surgery
Above image is post op photo afterwidening is done
|Nasal cavity||Polypectomy, partial inferior turbinectomy|
|Oropharynx||Tonsillectomy, UPPP, LAUP, Zetaplasty, Palatal implants|
|Hypopharynx||Midline glossectomy, tongue base reduction|
|Mandibular advancement, genioglossal advancement, hyoid myotomy suspension|
|Oro and hypophanrynx||Maxillomandibular advancement, epiglottoplasty|
|Bypass of the airway||Tracheostomy|