Management of palatal snoring, Z palatoplasty and uvulopalatopharyngoplasty

Abstract

IntroductionSnoring is “to breathe during sleep with harsh, snorting noises caused by vibration of the soft palate”. Naturally occurring or drug-induced sleep is a requirement for its appearance. Snoring is the audible sign of increased upper airway resistance. It is known to be an important clinical hallmark of OSA (Nakano et al., 2003) and, as such, may be a useful and an easily accessible marker to screen for obstructive SDB. Materials and methodsThis study was conducted in the Department of Otorhinolaryngology Head and Neck Surgery, Government Medical College, Srinagar and includes 37 patients who presented in our OPD themselves with complaints of snoring or are referred from some other speciality or institution. After thorough history taking and examination all patients were evaluated with Muller’s maneuver, overnight polysomnography and intensity of snoring sound were measured with the help of sound level meter. All patients with Muller’s maneuver documented soft palatal obstruction and PSG documented snoring were distributed into two treatment groups 17 patients in the Z palatoplasty group and 20 patients in the UP3 group depending on the grade of tonsillar hypertrophy. ResultsThis study showed that there was a statistically significant (P<0.05) improvement in the percentage of snoring and intensity of snoring after 3weeks, 3months and 6months of treatment in both Z palatoplasty and UP3 groups of patients. ConclusionThis study showed that Z palatoplasty and UP3 are best treatment options for patients with palatal snoring without tonsillar hypertrophy and with tonsillar hypertrophy respectively.