As we know Snoring is multifactorial and identifying the areas of obstruction is most important. Nasal obstruction contributes 20-30% of all snoring and OSA problems.
People who snore may suffer from a nasal problem: A stuffy or blocked nose requires extra effort to pull air through it. This creates an exaggerated vacuum in the throat, and pulls together the floppy tissues of the throat. Snoring results. Deformities of the nose or nasal septum, such as a deviated septum, nasal polyps, enlarged adenoids, sinusitis, and other abnormalities can cause such an obstruction.
The main types of nasal surgery are septoplasty, turbinate reductions, Nasal polypectomy and nasal valve surgery. A septoplasty involves removing excess septal cartilage and reshaping the cartilage to bring it to the midline. The procedure is usually done under general anesthetic.
The nasal turbinate are bones with a soft tissue covering that come off the side walls on the inside of your nose. These can cause nasal blockage if the bone is too thick or if the soft tissue covering the turbinates is too thick. There are many ways to perform a turbinate reduction which reduce the amount of the soft tissue and/or bone in the turbinates. Laser turbinectomy,Submucus diathermy,Coblation turbinoplasty are the procedure I usually perform.
Nasal Polypectomy can help restore nasal airway. Nasal polypectomy using Micro debrider is the best way to remove them.
Nasal valve procedures are used for people with a narrow nasal valve or nasal valve collapse. This can be widened by simple excision of few mm wedge of skin in the nasal valve area.
There is conflicting data on the effects of nasal surgery on snoring and sleep apnea. Most studies suggest improvement, although on its own it is unlikely to provide a cure. If the nose is a main site of obstruction (usually from a deviated nasal septum, turbinate hypertrophy, or nasal polyps), treatment will improve nasal airflow.
As part of multilevel surgery, if nasal obstruction is significant, I usually recommend surgical repair to treat snoring and it helps.
Nasal Surgery and CPAP
If nose is blocked, wearing a CPAP will be extremely difficult. The reason for CPAP failure or non compliance is due to the fact that patients are unable to breathe thru their nose comfortably. So relieving nasal blockage helps them CPAP compliant.