Abstract :
Aim: To assess the incidence of nasal and nasopharyngeal obstruction in patients with abnormal polysomnography. To correlate the levels of nasal and nasopharyngeal obstruction with degree of obstructive sleep apnoea (OSA).
Materials and Methods: Polysomnography by RMS Quest 32 polysomnography machine. Anterior and posterior rhinoscopy using Thudicum’s nasal speculum and posterior rhinoscopy mirror respectively. Nasal endoscopy to visualise nasal and nasopharyngeal airway for obstruction using 0 Hopkin’s rod endoscope under topical anaesthesia using 4% Xylocaine.
Results: 31 patients had deviated nasal septum (DNS), 19 had hypertrophied turbinates, 4 had Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP). 21 patients had posterior DNS, 7 had postnasal drip. By Nasal Endoscopy 42 patients had DNS among which 20 had anterior, 15 had posterior deviation. 7 patients had both anterior and posterior DNS. 4 patients had CRSwNP, 7 CRSsNP (Chronic Rhinosinusitis sans Nasal Polyposis), 3 had concha bullosa. Retropalatal obstruction was classified according to Mullers grade, where we found 10% patients had grade I, 28.75% grade II, 28.75% grade III and 32.5% grade IV obstruction. P value of DNS was 0.60 whereas that of other types of nasal obstruction was 0.85. Correlation of Retropalatal obstruction was significantly high with severity of OSA with P value
Conclusion: 1-year incidence of Nasal and Nasopharyngeal obstruction in patients with OSA is 0.67 per 1000 population. Degree of OSA has poor correlation with levels of nasal obstruction and strong correlation with grades of retropalatal obstruction.
Keyword :
Obstructive Sleep Apnea, Polysomnography, Deviated Nasal Septum, Nasal Endoscopy, Retropalatal obstruction