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Background and Objectives Snoring is the most common symptom of obstructive sleep apnea (OSA) and is caused by turbulent airflow due to narrowing of the upper airways. In patients with positional OSA, a change in sleep posture from supine to lateral is known to reduce snoring and sleep apnea. This study was performed to compare changes in snoring sound intensity and formant frequencies according to sleep position.Subjects and Method A total of 19 patients (male: 18; female: 1) diagnosed with positional OSA by polysomnography (PSG) were enrolled in this study. The snoring sounds recorded during PSG were analyzed acoustically and compared according to sleep position (i.e., supine vs. lateral).Results Snoring disappeared on changing sleep position in five patients, all of whom had Apnea-Hypopnea Index (AHI) <15. In other patients, the snoring sounds tended to decrease with posture change, and the degree of decrease was inversely proportional to AHI (p=0.015) and respiratory disturbance index (RDI) (p=0.013). Formant frequencies 1, 3, and 4 (F1, F3, and F4, respectively) decreased when sleeping in the lateral position (p=0.02, 0.03, and 0.01, respectively).Conclusion In patients with positional OSA, a change in sleep posture from supine to lateral during sleep reduced the intensity and frequency of snoring sound.

Background and Objectives:The orbit contains important structures such as the eyeball, optic nerve, and extraocular muscles. A defect the orbital wall is a clinically important anatomical variation because it can cause serious complications during nasal surgery. The authors investigated the incidence of orbital defects in patients of chronic sinusitis with nasal septal deviation and found out whether there is a relationship between chronic sinusitis and orbital defects to help the surgical treatment of these patients. Materials and Methods: The computed tomography (CT) and medical records of 247 patients with chronic sinusitis with septal deviation (study group) and 470 patients with septal deviation only (control group) were analyzed retrospectively. The average age of patients was 34.05 years for males and 33.67 years for females. Results: The incidence of orbital defects was statistically higher with 22 out of 247 subjects in the study group (8.9%) than 22 out of 470 subjects in the control group (4.7%)(Chi-square verification result, significance level 0.05). In both groups, the direction and degree of nasal septal deviation did not significantly affect the incidence of orbital defects, and medial orbital defects were the most common in both groups (study group, 90.9%, 20/22, control group, 86.4%, 19/22). Conclusions: About 9% of patients with chronic sinusitis with septal deviation showed defects of the orbital wall, which is easy to be damaged in sinus surgery and can lead to permanent complications. We should prevent such complications through evaluating CT and detailed medical history of the patient before surgery.

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Background and Objectives: Drug-induced sleep endoscopy (DISE) is widely used to diagnose obstructive sleep apnea syndrome (OSAS). Palatine tonsil hypertrophy is a frequently encountered potential source of upper airway obstruction. Here, we determined whether the pre-surgery size of the palatine tonsil could be used to predict the extent and pattern of upper airway obstruction during DISE of adults with OSA. Materials and Methods: We retrospectively evaluated 268 patients (mean age 42.80±12.34 years, range 17-73 years) who underwent polysomnography and were diagnosed with OSAS in a single medical center from 2013 to 2020. The Brodsky tonsil scores of all subjects were obtained via physical examination. DISE proceeded with each patient supine. The extent of obstruction was evaluated by dividing the upper airway into retropalatal and retrolingual levels (the Koo's DISE classification system). Data were analyzed via simple linear regression. A p<0.05 was considered statistically significant. Results: We found relationships between the Brodsky tonsil score and the extents of obstruction at the retropalatal level. A significantly negative relationship between the score and retropalatal anteroposterior collapse was apparent (slope coefficient -0.115, p<0.05), as well as a significantly positive relationship between the score and retropalatal lateral collapse (slope coefficient 0.274, p<0.05). However, at the retrolingual level, no significant relationship was apparent between the Brodsky score and the extent of obstruction (p>0.05). Conclusion: In adult patients with OSA, as the palatine tonsil size increased, lateral pharyngeal wall obstruction at the retropalatal level became more severe, and the pattern of upper airway collapse at that level tended to be lateral rather than anteroposterior or concentric.