Laser Palatoplasty versus Laser Palatoplasty and Laser Turbinectomy for Snoring and Mild Obstructive Sleep Apnea

Abstract

Background: Patients with obstructive sleep apnea (OSA) have both anatomic and physiologic dysfunction of the upper airway during sleep resulting in repeated airway obstruction and varying degrees of hypoxemia. In patients with obstructive sleep apnea suffering from both snoring and nasal obstruction, nasal surgery relieves snoring and improves apnea/hypopnea index (AHI), lowest O2 saturation (LOS), epworth sleepness scale (ESS) and snoring severity scale (SSS) by different proportions. Objective: To compare AHI, SSS, and ESS in laser palatoplasty and combined laser palatoplasty and laser turbinoplasty. Patients and Methods: All patients underwent surgery had snoring and mild OSA symptoms, aged between 20 and 60 years with continuous positive airway pressure (CPAP) refusal, failure or non-compliance, classified according to type of surgical intervention into: group A 14 patients were treated with laser palatoplasty and laser turbinoplasty. Group B: 14 patients were treated with laser palatoplasty only. Pre and postoperative sleep study, Epworth sleepiness scale, and snoring score were reported and compared. Results: As regard AHI there was no significant difference between 2 groups at pre or post, according to ESS (epworth sleepness scale) there was no significant difference between 2 groups pre and post. Regarding SSS the preoperative snoring score was reported to be significantly more in patients who had associated nasal obstruction (group A). But after surgery, the difference in postoperative values was nonsignificant reflecting the value of performing nasal surgery in this group of patients. Conclusion: Combined nasal and palatal surgery is more effective for snoring and mild OSA than palatal surgery only.