Anatomical analysis of nasal cavity in stuffy patient with snoring

Abstract

The stuffy patient with snoring is common. After septal surgery, snoring symptom is improved often. So when evaluating patients with snoring for septoplasty, it is important to assess for nasal airway obstruction. In this study, we evaluated the relationship between subjective nasal obstruction and the corresponding anatomic nasal parameters in patients with nasal obstruction and snoring using PNS CT so as to acquire better result. Between March 2009 and February 2012, A total of 90 patients who underwent PNS CT imaging for preoperative evaluation were divided into 2 groups; 50 patients with nasal septal deviation who underwent septoplasty with nasal obstruction and snoring were enrolled in the study group and 40 patients without nasal septal deviation who underwent transsphenoid pituitary tumor operation without nasal obstruction were enrolled in the control group. The subjective nasal obstruction was measured by NOSE scale and NO-VAS. A preoperative coronal CT image was used for calculation of both nasal cavity cross-sectional areas at the three level of the internal nasal valve, ostiomeatal unit (OMU) and choana and used for calculation of septal deviation angle at the two level of internal nasal valve and OMU in both the study and control groups. We compared cross-sectional areas and septal deviation angles derived from both groups and evaluated the relationship between subjective nasal obstruction and the anatomic nasal parameters in the study group. In the study group, there was correlation between subjective nasal obstruction and the septal deviation angle, the sum of both nasal cavity cross-sectional areas and the larger area of both nasal cavity cross-sectional areas respectively at the OMU level. And in the same group, there was correlation between subjective nasal obstruction and the sum of both nasal cavity cross-sectional areas, the larger area and the smaller area of both nasal cavity cross-sectional areas respectively at the choana level. There was a difference between the study group and the control group in all anatomical nasal parameters (septal deviation angle, the sum of both nasal cavity cross-sectional areas and the area gap between both nasal cavity cross-sectional areas) at the three level of internal nasal valve, OMU and choana. This study indicated that the septal deviation angle and nasal cavity cross-sectional areas at the level of OMU and choana are related to subjective nasal obstruction. So when we evaluate nasal obstruction in patients with snoring, the middle and posterior part patency of nasal cavity is also important along with anterior nasal valve part. The authors have no financial interest to declare in relation to the content of this paper. No outside funding was received.