Disclaimer: The information contained within the Grand Rounds Archive is intended for use by doctors and other health care professionals. These documents were prepared by resident physicians for presentation and discussion at a conference held at Baylor College of Medicine in Houston, Texas. No guarantees are made with respect to accuracy or timeliness of this material. This material should not be used as a basis for treatment decisions, and is not a substitute for professional consultation and/or peer-reviewed medical literature.Office-Based Management of SnoringAllen Lue, M.D. October 22, 1998 Case Presentation: T.S. is a 48 year-old white male who, according to his wife, presents with a several year history of loud snoring,. He experiences occasional daytime somnolence but feels he sleeps soundly without any difficulty, waking up rested. His wife, however, does not experience restful sleep. She moved to a separate room and is uncertain whether the patient has any apneic episodes. She does report hearing occasional choking noises. Past medical history is remarkable for hypertension. Past surgical history is unremarkable. Medications include tylenol for osteoarthritis. He smokes a pack per day for 30 years and drinks 2 to 3 beers a day. Physical exam: Moderately obese, no apparent distress. TM’s- gray, translucent. Nose- septum midline, mucosa pink. OC/OP- redundant soft palate and posterior tonsillar pillars with slightly elongated uvula, no tonsillar hypertrophy. Flexible fiberoptic laryngoscopy - no adenoid hypertrophy, BOT slightly enlarged, TVC mobile bilaterally without lesions. Neck - no masses or lymphadenopathy. A sleep study was obtained which revealed an Apnea/Hypopnea Index of 8 and a lowest saturation of 89%. Management options will be discussed. Bibliography: Ariyasu L, Young G, Spinelli F. Uvulectomy in the office setting. Ear Nose Throat J 1995; 74:721-722. Astor FC, Hanft KL, Benson C, Amaranath A. Analysis of short-term outcome after office-based laser-assisted uvulopalatoplasty. Otolaryngol Head Neck Surg 1998;118:478-480. Blythe WR, Henrich DE, Pillsbury HC. Outpatient uvuloplasty: an inexpensive, single-staged procedure for the relief of symptomatic snoring. Otolarygol Head Neck Surg 1995;113:1-4. Braver HM, Block AJ, Perri MG. Treatment for snoring: combined weight loss, sleeping on side and nasal spray. Chest 1995;107:1283-1288. Camilleri AE, Ramamurthy L, Jones PH. Sleep nasoendoscopy: what benefit to the management of snorers? J Laryngol Otol 1995;109:1163-1165. Coleman, JA. Laser-assisted uvulopalatoplasy: long-term results with a treatment for snoring. Ear Nose Throat J 1998;77:22-34. Fairbanks DN, Fujita S. Snoring and Obstructive Sleep Apnea. Raven Press: New York, 1994. Gnuechtel MM, Keyser JS, Greinwald JH, Postma GN. Electrocautery versus carbon dioxide laser for uvulopalatoplasty for the treatment of snoring. Laryngoscope 1997;107:848-854. Loth S, Petruson B. Improved nasal breathing reduces snoring and morning tiredness. Arch Otolaryngol Head Neck Surg 1996;122:1337-1340. Maw J, Marsam J. Uvulopalatopharyngoplasty versus laser-assisted uvulopalatopharyngoplasy in the treatment of snoring. J Otolaryngol 1997;26:232-235. Olson LG, King MT, Hensley MJ, Saunders NA. A community study of snoring and sleep-disordered breathing: health outcomes. Am J Resp Crit Care Med 1995;152:717-720. Pinczower EF. Globus sensation after laser-assisted uvulopalatoplasy. Am J Otolaryngol 1998;19:107-108. Powell NB, Riley RW, Troell RJ, Blumen MB, Guilleminault C. Radiofrequency volumetric reduction of the tongue: a porcine pilot study for the treatment of obstructive sleep apnea syndrome. Chest 1997;111:1348-1355. Powell NB, Riley RW, Troell RJ, Li K, Blumen MB, Guilleminault C. Radiofrequency volumetric tissue reduction of the palate in subjects with sleep disordered breathing. Chest 1998;113:1163-1174. Pradham PS, Gliklich RE, Winkelman J. Screening for obstructive sleep apnea in patients presenting for snoring surgery. Laryngoscope 1996;106:1393-1397. Rausher H, Formanek D, Zwick H. Nasal continuous positive airway pressure for nonapneic snoring? Chest 1995;107:58-61. Schmidt-Nowara W, Lowe A, Wiegand L, Cartwright R, Perez-Guerra F, Menn S. Oral appliances for the treatment of snoring and obstructive sleep apnea: a review. Sleep 1995;18: 501-510. Schwartz RS, Salome NN, Ingmundon PT, Rugh JD. Effects of electrical stimulation to the soft palate for snoring and obstructive sleep apnea. J Prost Dent 1996;76: 273-281. Stradling JR, Negus TW, Smith D, Langford B. Mandibular advancement devices for the control of snoring. Eur Resp J 1998;11:447-450. Tarris DJ, Clerk AA, Norbash AM, Troell RJ. Characterization of postoperative edema following laser-assisted uvulopalatoplasy using MRI and polysomnography. Laryngoscope 1996;106:124-128. Ulfberg J, Fenton G. Effect of Breathe Right nasal strip on snoring. Rhinology 1997;35: 50-52. Walker RP, Gopalsami C. Laser-assisted uvulopalatoplasty: postoperative complications. Laryngoscope 1996;106:834-838. Young T, Finn F, Kim H. Nasal obstruction as a risk factor for sleep disordered breathing. JAllergy Clin Immunol 1997;99:S752-S757. Click here to view slides from this presentation. Grand Rounds Archive | Department Home page BCM Public | BCM Intranet | Privacy Notices | Contact BCM | BCM Site Map | ©2001-2006 Baylor College of Medicine
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