Effective Treatments for Severe Snoring After Nasal Surgery - Otolaryngology

Dr. Ye Dawei reply Otolaryngology

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Dear Sir/Madam, the septoplasty may not completely resolve the snoring issue.
Please come in for a detailed examination.
My clinic hours are Monday, Wednesday, Thursday, and Friday mornings.
Attached is an article for your reference.

"The sound of snoring has become thunderous" – Snoring and Sleep Apnea Syndrome
In Su Dongpo's poem "Linjiang Xian," he vividly describes the sound of snoring as thunderous, creating a sense of immersion.
In the ENT clinic, it is common to see numerous patients, regardless of age, who are compelled by family members or partners to seek treatment due to loud snoring.
Family members often fear that the patient may experience sudden death due to respiratory cessation.
Below is a brief introduction to snoring and the more severe condition known as sleep apnea syndrome.
"Snoring" refers to the vibration of soft tissues in the soft palate during oral breathing, which produces sound due to airflow.
More severely, "sleep apnea syndrome" not only includes snoring but also other symptoms such as observable respiratory cessation during sleep, sudden awakenings, difficulty breathing, frequent urination, choking, and coughing.
During the day, patients may experience poor energy levels, lack of concentration, memory decline, restlessness, and excessive daytime sleepiness due to poor sleep quality.
Under normal circumstances, both adults and children should not snore if they are breathing through their noses.
Snoring occurs when mouth breathing causes airflow to vibrate the soft tissues of the soft palate.
Therefore, snoring is more common in patients with upper respiratory infections or allergic rhinitis.
Children may snore due to enlarged adenoids causing nasal obstruction, while adults, particularly overweight middle-aged men with short necks, large tongues, or short jaws, are more likely to snore due to the necessity of mouth breathing.
"Sleep apnea syndrome" refers to intermittent cessation of breathing during sleep due to airway obstruction, characterized by more than five episodes of breathing cessation per hour, with each episode lasting longer than ten seconds.
During these cessation periods, chest movements may be observed, but airflow through the mouth and nose is absent or minimal.
The obstruction may occur in the nasal area, soft palate, or base of the tongue.
This obstruction leads to decreased blood oxygen levels and increased carbon dioxide levels, stimulating the respiratory center to initiate forceful breathing, resulting in snoring.
This process repeats throughout the sleep period.
To accurately diagnose this condition, it is crucial to consider the descriptions provided by family members regarding the patient's sleep patterns, along with the patient's self-reported sleep quality and daytime alertness.
Additionally, a clinical examination of potential obstruction sites in the nose, mouth, tongue, jaw, or throat, as well as an assessment of whether the patient is overweight, is essential.
Hospitals can utilize sleep questionnaires, physiological monitoring devices, nocturnal oxygen monitoring, skull X-rays, CT scans, and even MRIs to observe changes in snoring, eye movements, brain waves, blood pressure, heart rate, muscle activity, and blood oxygen levels during sleep.
A fiberoptic endoscope can simulate the narrowing of the oropharynx during sleep.
The easiest condition to treat is snoring caused by nasal obstruction, which can be resolved with medications or surgery to clear the nasal passages.
However, treatment for sleep apnea syndrome is less effective with medications.
Initially, physicians will emphasize the importance of weight loss, maintaining a regular schedule, engaging in appropriate exercise, avoiding smoking and alcohol, and refraining from medications that may cause muscle relaxation, such as sedatives, tranquilizers, or antihistamines.
Snoring or mild sleep apnea syndrome can be treated surgically under local anesthesia using lasers, radiofrequency, or local sclerosing agents.
Surgical treatment for moderate to severe sleep apnea syndrome is more complex and typically requires general anesthesia for uvulopalatopharyngoplasty (UPPP).
More extensive procedures may include mandibular advancement, tongue base reduction, and hyoid suspension, all aimed at increasing airway space and enhancing the strength of surrounding tissues to prevent symptoms caused by tissue relaxation in the relevant areas.

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Reply Date: 2005/03/28