비강수술이 인두기도에 미치는 영향 분석
The Efficacy of Nasal Surgery on Pharyngeal Airway
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Background and Objectives Nasal surgery is known to improve the quality of life in patientswith obstructive sleep apnea; however, its effect on the airway structure is little known. This study attempted to identify the impact of nasal surgery on the pharyngeal airway structure. Subjects and Method We enrolled in the study patients who underwent nasal surgery fromJuly 2015 to March 2018 due to nasal obstruction with severe snoring or sleep apnea. Patientswith palate surgery or previous history of airway surgery were excluded. Demographic factors,symptoms regarding nasal obstruction, sleep study, preoperative cephalometry, and postoperative3-month cephalometry were taken into account and analyzed. We also performed asubgroup analysis according to the severity of sleep apnea. Results Sixty-three patients were enrolled in this study. Soft palate thickness showed no significantchange. Pre and postoperative soft palate thickness were 10.82±3.00 and 11.11±3.35(p=0.261), respectively. However, the pharyngeal airway space was enlarged via nasal surgeryfrom 12.05±3.35 to 13.04±3.35 (p=0.006), respectively. The subgroup analysis showed that thepharyngeal airway was mainly enlarged in the patients with lower Apnea-Hypopnea Index (AHI). Conclusion Although nasal surgery does not reduce soft palate thickness, it can enlarge thepharyngeal airway space. The effect of surgery would be more prominent in patients withAHI of lower than 15 event/hour (p=0.005) as nasal surgery alone does not affect the pharyngealairway of patients with AHI greater than 15.
Abstract
Background and Objectives Nasal surgery is known to improve the quality of life in patientswith obstructive sleep apnea; however, its effect on the airway structure is little known. This study attempted to identify the impact of nasal surgery on the pharyngeal airway structure. Subjects and Method We enrolled in the study patients who underwent nasal surgery fromJuly 2015 to March 2018 due to nasal obstruction with severe snoring or sleep apnea. Patientswith palate surgery or previous history of airway surgery were excluded. Demographic factors,symptoms regarding nasal obstruction, sleep study, preoperative cephalometry, and postoperative3-month cephalometry were taken into account and analyzed. We also performed asubgroup analysis according to the severity of sleep apnea. Results Sixty-three patients were enrolled in this study. Soft palate thickness showed no significantchange. Pre and postoperative soft palate thickness were 10.82±3.00 and 11.11±3.35(p=0.261), respectively. However, the pharyngeal airway space was enlarged via nasal surgeryfrom 12.05±3.35 to 13.04±3.35 (p=0.006), respectively. The subgroup analysis showed that thepharyngeal airway was mainly enlarged in the patients with lower Apnea-Hypopnea Index (AHI). Conclusion Although nasal surgery does not reduce soft palate thickness, it can enlarge thepharyngeal airway space. The effect of surgery would be more prominent in patients withAHI of lower than 15 event/hour (p=0.005) as nasal surgery alone does not affect the pharyngealairway of patients with AHI greater than 15.
참고문헌 (25)
- Young T, "Epidemiology of obstructive sleep apnea : a population health perspective", Am J Respir Crit Care Med, 165(9), pp.1217~1239 (2002)
- 박우성, "Long-Term Effects of Adenotonsillectomy on Growth and Symptoms in Childhood", 대한이비인후-두경부외과학회지, 61(12), pp.681~685 (2018), 대한이비인후과학회[DOI]
- 김대웅, "폐쇄성 수면무호흡증후군 수술 후 잔존 증상이 남아 있는 환자에서 코 수술이 증상 호전에 미치는 영향", 대한이비인후-두경부외과학회지, 59(8), pp.588~592 (2016), 대한이비인후과학회[DOI]
- Li HY, "Improvement in quality of life after nasal surgery alone for patients with obstructive sleep apnea and nasal obstruction", Arch Otolaryngol Head Neck Surg, 134(4), pp.429~433 (2008)
- 장현욱, "비중격 교정술 및 비갑개성형술이 수면 호흡장애 환자의 삶의 질에 미치는 영향", 대한이비인후-두경부외과학회지, 54(4), pp.257~264 (2011), 대한이비인후과학회
- Camacho M, "The effect of nasal surgery on continuous positive airway pressure device use and therapeutic treatment pressures : A systematic review and meta-analysis", Sleep, 38(2), pp.279~286 (2015)
- Kim ST, "Polysomnographic effects of nasal surgery for snoring and obstructive sleep apnea", Acta Otolaryngol, 124(3), pp.297~300 (2004)
- Koutsourelakis I, "Randomised trial of nasal surgery for fixed nasal obstruction in obstructive sleep apnoea", Eur Respir J, 31(1), pp.110~117 (2008)
- Berry RB, "AASM scoring manual updates for 2017 (version 2.4)", J Clin Sleep Med, 13(5), pp.665~666 (2017)
- Wu J, "Apneahypopnea index decreased significantly after nasal surgery for obstructive sleep apnea: A meta-analysis", Medicine(Baltimore), 96(5), pp.e6008~ (2017)
- Roh HJ, "The Effect of Nasal Obstruction on Sleep Apnea", Korean J Otorhinolaryngol-Head Neck Surg, 43(6), pp.626~630 (2000)
- Nakata S, "Nasal resistance for determinant factor of nasal surgery in CPAP failure patients with obstructive sleep apnea syndrome", Rhinology, 43(4), pp.296~299 (2005)
- Nowak C, "Nasal obstruction and compliance to nasal positive airway pressure", Ann Otolaryngol Chir Cervicofac, 120(3), pp.161~166 (2003)
- Friedman M, "Effect of improved nasal breathing on obstructive sleep apnea", Otolaryngol Head Neck Surg, 122(1), pp.71~74 (2000)
- Esteller E, "Adverse effects of continuous positive airway pressure therapy and its relation to the nose", Acta Otorrinolaringol Esp, 55(1), pp.17~22 (2004)
- Hollandt JH, "Nasal breathing and continuous positive airway pressure(CPAP)in patients with obstructive sleep apnea(OSA)", Sleep Breath, 7(2), pp.87~94 (2003)
- Ripberger R, "Nasal positive pressure ventilation (nCPAP) in therapy of obstructive sleep apnea: acceptance by 50patients", Laryngorhinootologie, 73(11), pp.581~585 (1994)
- Sériès F, "Effects of surgical correction of nasal obstruction in the treatment of obstructive sleep apnea", Am Rev Respir Dis, 146(5 Pt 1), pp.1261~1265 (1992)
- Kurt G, "Cephalometric comparison of pharyngeal airway in snoring and non-snoring patients", Eur J Dent, 5(1), pp.84~88 (2011)
- Embree PM, "Volumetric blood flow via time-domain correlation : Experimental verification", IEEE Trans Ultrason Ferroelectr Freq Control, 37(3), pp.176~189 (1990)
- Miller RW, "Flow measurement engineering handbook" (1983), McGraw Hill
- 박찬순, "수면, 수면질환 그리고 코의 역할", 대한이비인후-두경부외과학회지, 55(4), pp.201~205 (2012), 대한이비인후과학회[DOI]
- Gold AR, "The whys and hows of using nasal continuous positive airway pressure diagnostically", Chest, 110(4), pp.1077~1088 (1996)
- Löth S, "Better quality of life when nasal breathing of snoring men is improved at night", Arch Otolaryngol Head Neck Surg, 125(1), pp.64~67 (1999)
- Miyazaki S, "Influence of nasal obstruction on obstructive sleep apnea", Acta Otolaryngol Suppl, 537, pp.43~46 (1998)