A GRADING SYSTEM FOR PATIENTS WITH OBSTRUCTIVE SLEEP-APNEA - BASED ONSLEEP NASOENDOSCOPY

One of the most important parts of the management of patients with the obstructive sleep apnoea syndrome is the assessment of the level of o bstruction in order to allow the appropriate choice of treatment. We h ave recently developed the technique of sleep nasendoscopy which allow s direct visualization of the site of obstruction in the sleeping pati ent. Having performed over a hundred of these investigations we are ab le to suggest a grading system for these patients dividing them into f ive grades. Grade 1 = simple palatal level snoring; grade 2 = single p alatal level obstruction; grade 3 = palatal level obstruction with int ermittent orohypopharyngeal involvement; grade 4 = sustained multi-seg ment involvement; grade 5 = tongue-base level obstruction. We feel tha t this grading system will help in deciding which patients are suitabl e for surgery and which are not; hence avoiding unnecessary operations and allowing a more logical decision on the appropriate form of treat ment. Results of the first 90 patients to have sleep nasendoscopy are presented.