What is the role of nasal reconstruction in the treatment of obstructive sleep apnea (OSA)?

Updated: Feb 25, 2021
  • Author: Charles E Morgan, DMD, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

Relief of nasal obstruction alone rarely cures OSA; however, patient tolerance and response to nasal CPAP are often improved. Septoplasty, septorhinoplasty, and turbinate reduction may be indicated in patients who have a predisposed anatomy.

Turbinates can be reduced in a number of different ways, including through traditional total or partial turbinectomies, submucous resection, cryotherapy, laser vaporization, bipolar radiofrequency coblation, and radiofrequency ablation. The author has found the lateral crural J-flap procedure to be useful in patients with external nasal valve collapse who have had trouble tolerating CPAP with the nasal pillows mask. [6] Radiofrequency turbinate ablation is demonstrated below.

Bipolar radiofrequency cold ablation turbinate red Bipolar radiofrequency cold ablation turbinate reduction for obstructive inferior turbinate hypertrophy. Depiction of linear passage of the coblation wand. Reprinted with permission from Elsevier [Bhattacharyya N and Kepnes LJ. Bipolar radiofrequency cold ablation turbinate reduction for obstructive inferior turbinate hypertrophy. Operative Techniques in Otolaryngology-Head and Neck Surgery. 2002;13(2):170-4].

 

Bipolar radiofrequency cold ablation turbinate red Bipolar radiofrequency cold ablation turbinate reduction for obstructive inferior turbinate hypertrophy. Anterior rhinoscopic view of the coblation wand as it enters the anterior head of the right inferior turbinate. Reprinted with permission from Elsevier [Bhattacharyya N and Kepnes LJ. Bipolar radiofrequency cold ablation turbinate reduction for obstructive inferior turbinate hypertrophy. Operative Techniques in Otolaryngology-Head and Neck Surgery. 2002;13(2):170-4].

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