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The main types of nasal surgery are septoplasty, turbinate reductions, and nasal valve surgery. I will address each of these in more detail in their own section but here is a brief overview.
The nasal septum is the cartilage in the middle of your nose. It is often shifted to one side which can result in nasal blockage. 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 (you are asleep).
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 tubinates 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.
Nasal valve procedures are used for people with a narrow nasal valve or nasal valve collapse. The nasal valve is the narrowest area of your nose and is located about 1cm inside your nose. It is at the same area as the crease above your nostril. In some people, this area is too narrow. In others, when they breath in this area collapses on itself blocking the airway off. Again there are many ways to widen and stiffen this area.
Overall, nasal surgery has a fairly quick recovery with most people back at work within a week regardless of technique. There are some techniques which speed recovery and return to work. Although the nose is not the site of snoring, a blocked nose often plays a mojor role by forcing mouth breathing, creating an unfavorable 'upstream' drag, and worsening the Bernoulli effect. These all cause other areas of your throat to vibrate and you to snore.
Does fixing a blocked nose Stop Snoring and Sleep Apnea?
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), treatement will improve nasal airflow. One would think this should improve snoring but in a study by Friedman et al. shows sometimes things get worse:
“Improvement in nasal airway (septoplasty) without palatal treatment often results in increased air flow with louder snoring and worsening of (sleep apnea)” (Friedman et al. Effect of improved nasal breathing on obstructive sleep apnea. Otolaryngology-Head and Neck Surgery 2000;122:71-74).
As a comparison, a recent article published in the April 2008 issue of Archives of Otolaryngology was done by researchers in Taiwan. Their study included 51 patients (50 men and one woman, average age 39) with Sleep Apnea and symptoms of nasal blockage who were assessed before and three months after they had nasal surgery.
After surgery, there was a significant reduction in symptoms of nasal obstruction, in snoring, in daytime sleepiness, and a significant improvement in overall quality of life.
"These results suggest that, when nasal obstruction in OSA patients was relieved, their generic health improved, and that the effects were especially remarkable in reducing role limitations caused by physical or emotional problems," they added.
The main difference between these studies is obviously the patient population - Asian in the Taiwan article whereas it is mostly caucasion in the US study.
When considering contradicting articles, you have to consider that both may be correct. There are likely some people who will get better with nasal surgery, and others who will need palatal surgey as well. At this point, no study has shown how to accurately predict outcome.
If nasal obstruction is significant, I usually recommend surgical repair to treat snoring and because I believe it will help reduce recurrences.
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