SNORING AND SLEEP-APNEA SYNDROME - SURGIC AL-TREATMENT AND MESAM-IV-CONTROLLED, POSTOPERATIVE RESULTS

Approximately 20 % of the population snore. Snoring is caused by a vib ration of oropharyngeal soft tissues during air flow.The anatomical or igin of snoring can be the soft palate with a hyperplastic uvula or th e region of the base of tongue. An uvulopalatopharyngoplasty (UPPP) as a mode of surgical treatment is only appropriate in the first case. A patient can be considered to be suffering from sleep apnea syndrome i f snoring is associated with a temporary complete obstruction of the u pper airway with a subsequent decrease in oxygen saturation. In this c ase continuous positive airway pressure (CPAP) therapy can be benefici al; however, the role of surgery is confined to those operations provi ding unimpaired nasal air flow. Following extensive preoperative diagn ostics, including sleep monitoring with the MESAM-IV-system, 68 patien ts with palatal snoring underwent surgery. 46 could be examined 6 to 8 months postoperatively: In 41 patients snoring disappeared completely or was reduced to a few occasional episodes. 5 patients continued to snore after the UPPP. These patients were obese at the time of surgery and a preoperative attempt to lose weight was only partially successf ul. Although we identified the soft palate as the probable cause of sn oring by fiberoptic examination, especially the overweight patients be ar the risk of additional narrow segments in the region of the base of the tongue. The appropriate weight loss is therefore a fundamental pr erequisite for successful treatment. 5 patients with sleep apnea syndr ome combined with nasal obstruction underwent septum, turbinate and si nus surgery to create unobstructed nasal airflow. The following CPAP t reatment was of great benefit to them. With these MESAM-IV-controlled postoperative results we were able to demonstrate that the UPPP, combi ned with nasal surgery if necessary, is a successful treatment of pala tal snoring.