Inferior Turbinate classification system, grades 1 to 4: Development and validation study

Camacho, Macario; Zaghi, Soroush; Certal, Victor; Abdullatif, José; Means, Casey; Acevedo, Jason L.; Liu, Stanley Yung‐Chuan; Brietzke, Scott E.; Kushida, Clete A.; Capasso, Robson

doi:10.1002/lary.24923

Cited by 88 publications

(67 citation statements)

References 20 publications

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“…Grade 1 inferior turbinate occupies 0% to 25% of the total airway space, grade 2 occupies 26% to 50%, and so forth. 16 Recently, a severity classification system has been developed to provide a clinical context to patient-reported NOSE scores. NOSE scores were obtained from 345 patients with and without nasal obstructive symptoms.…”

Section: Clinician-derived Measuresmentioning

confidence: 99%

Evidence-Based Medicine

Lee

Most

2015

Facial Plastic Surgery Clinics of North America

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Section: Clinician-derived Measuresmentioning

confidence: 99%

Evidence-Based Medicine

Lee

Most

2015

Facial Plastic Surgery Clinics of North America

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“…Although the internal structures of the nose (i.e., turbinates [1], septum [2]) do not generally move in a dynamic fashion, they can become edematous with associated symptoms of congestion and obstruction. It is known that the nose may contribute to snoring [3] and obstructive sleep apnea (OSA) when congested or obstructed.…”

Section: Introductionmentioning

confidence: 99%

Nasal Dilators (Breathe Right Strips and NoZovent) for Snoring and OSA: A Systematic Review and Meta-Analysis

et al. 2016

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Objective. To systematically review the international literature for studies evaluating internal (NoZovent) and external (Breathe Right Strips) nasal dilators as treatment for obstructive sleep apnea (OSA). Study Design. Systematic review with meta-analysis. Methods. Four databases, including PubMed/MEDLINE, were searched through September 29, 2016. Results. One-hundred twelve studies were screened, fifty-eight studies were reviewed, and fourteen studies met criteria. In 147 patients, the apnea-hypopnea index (AHI) was reported, and there was an improvement from a mean ± standard deviation (M ± SD) of 28.7 ± 24.0 to 27.4 ± 23.3 events/hr, p value 0.64. There was no significant change in AHI, lowest oxygen saturation, or snoring index in OSA patients when using nasal dilators. However, a subanalysis demonstrated a slight reduction in apnea index (AI) with internal nasal dilators (decrease by 4.87 events/hr) versus minimal change for external nasal dilators (increase by 0.64 events/hr). Conclusion. Although nasal dilators have demonstrated improved nasal breathing, they have not shown improvement in obstructive sleep apnea outcomes, with the exception of mild improvement in apnea index when internal nasal dilators were used.

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“…Physical examination reveals that the patient is 71 inches and 240 lbs (body mass index of 33.5 kg/m 2 ) with a blood pressure of 143/76. His nasal septum is straight and his inferior turbinates are nonobstructing bilaterally (grades 1 or 2) [5]. He has a high-arched and narrow hard palate, an overjet of 3 mm, tongue scalloping, and a Grade 3 Friedman Palate Position [6].…”

Section: Case Presentationmentioning

confidence: 99%

Refractory Obstructive Sleep Apnea in a Patient with Diffuse Idiopathic Skeletal Hyperostosis

Darakjian

Chang

et al. 2016

Case Reports in Otolaryngology

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Diffuse Idiopathic Skeletal Hyperostosis (DISH) can cause ossification of ligaments and may affect the spine. We report a case of obstructive sleep apnea in a patient with significant upper airway narrowing secondary to cervical DISH. This patient had an initial apnea-hypopnea index (AHI) of 145 events/hour and was treated with uvulopalatopharyngoplasty, genial tubercle advancement, hyoid suspension, septoplasty, inferior turbinoplasties, and radiofrequency ablations to the tongue base which reduced his AHI to 40 events/hour. He redeveloped symptoms, was started on positive airway pressure (PAP) therapy, and later underwent a maxillomandibular advancement which improved his AHI to 16.3 events/hour. A few years later his AHI was 100.4 events/hour. His disease has gradually progressed over time and he was restarted on PAP therapy. Despite PAP titration, years of using PAP therapy, and being 100 percent compliant for the past three months (average daily use of 7.6 hours/night), he has an AHI of 5.1 events/hour and has persistent hypersomnia with an Epworth Sleep Scale questionnaire score of 18/24. At this time he is pending further hypersomnia work-up. DISH patients require prolonged follow-up to monitor the progression of disease, and they may require unconventional measures for adequate treatment of obstructive sleep apnea.

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Inferior Turbinate classification system, grades 1 to 4: Development and validation study

Abstract: 2c.

Cited by 88 publications

References 20 publications

Evidence-Based Medicine

Evidence-Based Medicine

Nasal Dilators (Breathe Right Strips and NoZovent) for Snoring and OSA: A Systematic Review and Meta-Analysis

Refractory Obstructive Sleep Apnea in a Patient with Diffuse Idiopathic Skeletal Hyperostosis

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