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HNO
Erschienen in: HNO 2/2017

04.11.2016 | Schlafapnoe | Leitthema

Behandlung der Nasenatmungsbehinderung bei Patienten mit obstruktiver Schlafapnoe

verfasst von: Prof. Dr. med. T. Verse, S. Wenzel

Erschienen in: HNO | Ausgabe 2/2017

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Zusammenfassung

Die Frage, welchen Einfluss die Behandlung einer eventuellen Nasenatmungsbehinderung bei obstruktiver Schlafapnoe (OSA) hat, wird auf Kongressen immer noch intensiv diskutiert. Grund hierfür sind vermutlich die sehr zwiespältigen Ergebnisse in Bezug auf die Verbesserung der Schlafqualität einerseits und den Schweregrad der OSA andererseits. Die Schlafqualität und damit die Erholfunktion des Schlafs verbessern sich hoch signifikant sowohl nach konservativer wie auch nach operativer Therapie einer Nasenatmungsbehinderung. Das hat auch Auswirkungen auf verschiedene Messparameter zur Bestimmung der Lebensqualität. Demgegenüber ist der Effekt einer konservativen oder operativen Verbesserung der Nasenluftpassage auf den Schweregrad einer OSA, gemessen im Apnoe-Hypopnoe-Index, von seltenen Ausnahmen abgesehen sehr gering. Es gibt aber erste Hinweise, dass sich bei einer erfolgreichen Nasenoperation der effektive Druck einer Ventilationstherapie reduzieren lässt.
Literatur
1.
Levinus Lemnious (1581) The touchstone of complexions. London
2.
Wells WA (1898) Some nervous and mental manifestations occuring in connection with nasal disease. Am J Med Sci 116:677–692CrossRef
3.
Ogura JH (1977) Presidential address. Fundamental understanding of nasal obstruction. Laryngoscope 87:1225–1232CrossRefPubMed
4.
Niinimaa V, Cole P, Mintz S, Shephard RJ (1981) Oronasal distribution of respiratory airflow. Respir Physiol 43:69–75CrossRefPubMed
5.
Olsen KD, Kern EB, Westbrook PR (1981) Sleep and breathing disturbance secondary to nasal obstruction. Otolaryngol Head Neck Surg 89:804–810CrossRefPubMed
6.
7.
Ferris BG Jr, Mead J, Opie LH (1964) Partitioning of respiratory flow resistance in man. J Appl Physiol 19:653–658PubMed
8.
Fitzpatrick MF, Driver HS, Chatha N, Voduc N, Girard AM (2003) Partitioning of inhaled ventilation between the nasal and oral routes during sleep in normal subjects. J Appl Physiol 94:883–890CrossRefPubMed
9.
10.
11.
Lavie P, Fischel N, Zomer J, Eliaschar I (1983) The effects of partial and complete mechanical occlusion of the nasal passages on sleep structure and breathing in sleep. Acta Otolaryngol 95:161–166CrossRefPubMed
12.
Suratt PM, Turner BL, Wilhoit SC (1986) Effect of intranasal obstruction on breathing during sleep. Chest 90:324–329CrossRefPubMed
13.
Miljeteig H, Hoffstein V, Cole P (1992) The effect of unilateral and bilateral nasal obstruction on snoring and sleep apnea. Laryngoscope 102:1150–1152CrossRefPubMed
14.
McNicholas WT, Tarlo S, Cole P, Zamel N, Rutherford R, Griffin D, Phillipson EA (1982) Obstructive apneas during sleep in patients with seasonal allergic rhinitis. Am Rev Respir Dis 126:625–628PubMed
15.
Meurice JC, Marc I, Carrier G, Sériès F (1996) Effects of mouth opening on upper airway collapsibility in normal sleeping subjects. Am J Respir Crit Care Med 153:255–259CrossRefPubMed
16.
Fitzpatrick MF, McLean H, Urton AM, Tan A, O’Donnell D, Driver HS (2003) Effect of nasal or oral breathing route on upper airway resistance during sleep. Eur Respir J 22:827–832CrossRefPubMed
17.
Zwillich CW, Pickett C, Hanson FN, Weil JV (1981) Disturbed sleep and prolonged apnea during nasal obstruction in normal men. Am Rev Respir Dis 124:158–160PubMed
18.
White DP, Cadieux RJ, Lombard RM, Bixler EO, Kales A, Zwillich CW (1985) The effects of nasal anesthesia on breathing during sleep. Am Rev Respir Dis 132:972–975PubMed
19.
McNicholas WT, Coffey M, McDonnell T, O’Regan R, Fitzgerald MX (1987) Upper airway obstruction during sleep in normal subjects after selective topical oropharyngeal anesthesia. Am Rev Respir Dis 135:1316–1319CrossRefPubMed
20.
Djupesland PG, Chatkin JM, Qian W, Cole P, Zamel N, McClean P, Furlott H, Haight JS (1999) Aerodynamic influences on nasal nitric oxide output measurements. Acta Otolaryngol 119:479–485CrossRefPubMed
21.
Blitzer ML, Lee SD, Creager MA (1996) Endothelium-derived nitric oxide mediates hypoxic vasodilation of resistance vessels in humans. Am J Physiol 271:H1182–H1185PubMed
22.
Leitzen KP, Brietzke SE, Lindsay RW (2014) Correleation between nasal anatomy and objective obstructive sleep apnea severity. Otolaryngol Head Neck Surg 150:325–331CrossRefPubMed
23.
Verse T, Dreher A, Heiser C, Herzog M, Maurer JT, Pirsig W, Rohde K, Rothmeier N, Sauter A, Steffen A, Wenzel S, Stuck BA (2016) S2e-Leitlinie „HNO-spezifische Therapie der obstruktiven Schlafapnoe des Erwachsenen“. ArGe Schlafmedizin der Deutschen Gesellschaft für Hals-, Nasen-, Ohren-Heilkunde, Kopf- und Halschirurgie. HNO 64:310–319CrossRefPubMed
24.
25.
Kerr P, Millar T, Buckle P, Kryger M (1992) The importance of nasal resistance in obstructive sleep apnea syndrome. J Otolaryngol 21:189–195PubMed
26.
Clarenbach CF, Kohler M, Senn O, Thurnheer R, Bloch KE (2008) Does nasal decongestion improve obstructive sleep apnea? J Sleep Res 17:444–449CrossRefPubMed
27.
Craig TJ, Mende C, Hughes K, Kakumanu S, Lehman EB, Chinchilli V (2003) The effect of topical nasal fluticasone on objective sleep testing and the symptoms of rhinitis, sleep, and daytime somnolence in perennial allergic rhinitis. Allergy Asthma Proc 24:53–58PubMed
28.
Hughes K, Glass C, Ripchinski M, Gurevich F, Weaver TE, Lehman E, Fisher LH, Craig TJ (2003) Efficacy of the topical nasal steroid budesonide on improving sleep and daytime somnolence in patients with perennial allergic rhinitis. Allergy 58:380–385CrossRefPubMed
29.
Stuck BA, Czajkowski J, Hagner AE, Klimek L, Verse T, Hörmann K, Maurer JT (2004) Changes in daytime sleepiness, quality of life, and objective sleep patterns in seasonal allergic rhinitis: a controlled clinical trial. J Allergy Clin Immunol 113:663–668CrossRefPubMed
30.
Kiely JL, Nolan P, McNicholas WT (2004) Intranasal corticosteroid therapy for obstructive sleep apnoea in patients with co-existing rhinitis. Thorax 59:50–55PubMedPubMedCentral
31.
Koutsourelakis I, Minaritzoglou A, Zakynthinos G, Vagiakis E, Zakynthinos S (2013) The effect of nasal tramazoline with dexamethasone in obstructive sleep apnoea patients. Eur Respir J 42:1055–1063CrossRefPubMed
32.
Höijer U, Ejnell H, Hedner J, Petruson B, Eng LB (1992) The effects of nasal dilation on snoring and obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 118:281–284CrossRefPubMed
33.
Metes A, Cole P, Hoffstein V, Miljeteig H (1992) Nasal airway dilation and obstructed breathing in sleep. Laryngoscope 102:1053–1055CrossRefPubMed
34.
Hoffstein V, Mateika S, Metes A (1993) Effect of nasal dilation on snoring and apneas during different stages of sleep. Sleep 16:360–365PubMed
35.
Wenzel M, Schönhofer B, Siemon K, Köhler D (1997) Nasal strips without effect on obstructive sleep apnea and snoring. Pneumologie 51:1108–1110PubMed
36.
Todorova A, Schellenberg R, Hofmann HC, Dimpfel W (1998) Effect of the external nasal dilator Breathe Right on snoring. Eur J Med Res 3:367–379PubMed
37.
Bahammam AS, Tate R, Manfreda J, Kryger MH (1999) Upper airway resistance syndrome: effect of nasal dilation, sleep stage, and sleep position. Sleep 22:592–598PubMed
38.
Gosepath J, Amedee RG, Romantschuck S, Mann WJ (1999) Breathe Right nasal strips and the respiratory disturbance index in sleep related breathing disorders. Am J Rhinol 13:385–389CrossRefPubMed
39.
Schönhofer B, Franklin KA, Brunig H, Wehde H, Köhler D (2000) Effect of nasal-valve dilation on obstructive sleep apnea. Chest 118:587–590CrossRefPubMed
40.
Djupesland PG, Skatvedt O, Borgersen AK (2001) Dichotomous physiological effects of nocturnal external nasal dilation in heavy snorers: the answer to a rhinologic controversy? Am J Rhinol 15:95–103CrossRefPubMed
41.
Amaro ACS, Duarte FHG, Jallad RS, Bronstein MD, Redline S, Lorenzi-Filho G (2012) The use of nasal dilator strips as a placebo for trials evaluating continuous positive airway pressure. Clinics 67:469–474CrossRefPubMedPubMedCentral
42.
Rubin AHE, Eliaschar I, Joachim Z, Alroy G, Lavie P (1983) Effects of nasal surgery and tonsillectomy on sleep apnea. Bull Eur Physiopathol Respir 19:612–615PubMed
43.
Dayal VS, Phillipson EA (1985) Nasal surgery in the management of sleep apnea. Ann Otol Rhinol Laryngol 94:550–554CrossRefPubMed
44.
Caldarelli DD, Cartwright R, Lilie JK (1985) Obstructive sleep apnea: variations in surgical management. Laryngoscope 95:1070–1073CrossRefPubMed
45.
Aubert-Tulkens G, Hamoir M, van den Eeckhaut J, Rodenstein DO (1989) Failure of tonsil and nose surgery in adults with long-standing severe sleep apnea syndrome. Arch Intern Med 149:2118–2121CrossRefPubMed
46.
Sériès F, Pierre SSt, Carrier G (1992) Effects of surgical correction of nasal obstruction in the treatment of obstructive sleep apnea. Am Rev Respir Dis 146:1261–1265CrossRefPubMed
47.
Sériès F, Pierre SSt, Carrier G (1993) Surgical correction of nasal obstruction in the treatment of mild sleep apnoea: importance of cephalometry in predicting outcome. Thorax 48:360–363CrossRefPubMedPubMedCentral
48.
Utley DS, Shin EJ, Clerk AA, Terris DJ (1997) A cost-effective and rational surgical approach to patients with snoring, upper airway resistance syndrome, or obstructive sleep apnea syndrome. Laryngoscope 107:726–734CrossRefPubMed
49.
Verse T, Pirsig W, Kroker BA (1998) Obstruktive Schlafapnoe und Polyposis nasi. Laryno-Rhino-Otol 77:150–152CrossRef
50.
Friedman M, Tanyeri H, Lim JW, Landsberg R, Vaidyanathan K, Caldarelli D (2000) Effect of nasal breathing on obstructive sleep apnea. Otolaryngol Head Neck Surg 122:71–74CrossRefPubMed
51.
Kalam I (2002) Objective assessment of nasal obstruction in snoring and obstructive sleep apnea patients: experience of a Police Authority Hospital. Ann Saudi Med 22:158–162PubMed
52.
Verse T, Maurer JT, Pirsig W (2002) Effect of nasal surgery on sleep related breathing disorders. Laryngoscope 112:64–68CrossRefPubMed
53.
Kim ST, Choi JH, Jeon HG, Cha HE, Kim DY, Chung YS (2004) Polysomnographic effects of nasal surgery for snoring and obstructive sleep apnea. Acta Otolaryngol 124:297–300CrossRefPubMed
54.
Balcerzak J, Przybylowski T, Bielicki P, Korczynski P, Chazan R (2004) Functional nasal surgery in the treatment of obstructive sleep apnea [in Polish]. Pneumonol Alergol Pol 72:4–8PubMed
55.
Nakata S, Noda A, Yagi H, Yanafi E, Mimura T, Okada T, Misawa H, Nakashima T (2005) Nasal resistance for determinant factor of nasal surgery in CPAP failure patients with obstructive sleep apnea syndrome. Rhinology 44:296–299
56.
Virkkula P, Bachour A, Hytönen M, Salmi T, Malmberg H, Hurmerinta K, Maasilta P (2006) Snoring is not relieved by nasal surgery despite improvement in nasal resistance. Chest 129:81–87CrossRefPubMed
57.
Koutsourelakis I, Georgoulopoulos G, Perraki E, Vagiakis E, Roussos C, Zakynthinos SG (2008) Randomised trial of nasal surgery for fixed nasal obstruction in obstructive sleep apnoea. Eur Resp J 31:110–117CrossRef
58.
Li HY, Lee LA, Wang PC, Chen NH, Lin Y, Fang TJ (2008) Nasal surgery for snoring in patients with obstructive sleep apnea. Laryngoscope 118:354–359CrossRefPubMed
59.
Nakata S, Noda A, Yasuma F, Morinaga M, Sugiura M, Katayama N, Sawaki M, Teranishi M, Nakashima T (2008) Effects of nasal surgery on sleep quality in obstructive sleep apnea syndrome with nasal obstruction. Am J Rhinol 22:59–63CrossRefPubMed
60.
Morinaga M, Nakata S, Yasuma F, Noda A, Yagi H, Tagaya M, Sugiura M, Teranashi M, Nakashima T (2009) Pharyngeal morphology: A determinant of successful nasal surgery for sleep apnea. Laryngoscope 119:1011–1016CrossRefPubMed
61.
Tosun F, Kemikli K, Yetkin S, Ozgen F, Durmaz A, Gerek M (2009) Impact of endoscopic sinus surgery on sleep quality in patients with chronic nasal obstruction due to nasal polyposis. J Craniofac Surg 20:446–449CrossRefPubMed
62.
Li HY, Lee LA, Wang PC, Fang TJ, Chen NH (2009) Can nasal surgery improve obstructive sleep apnea: Subjective or objective? Am J Rhinol Allergy 23:e51–e55CrossRefPubMed
63.
Bican A, Kahraman A, Bora I, Kahveci R, Hakyemez B (2010) What is the efficacy of nasal surgery in patients with obstructive sleep apnea syndrome? J Craniofac Surg 21:1801–1806CrossRefPubMed
64.
Choi JH, Kim EJ, Kim YS, Kim TH, Choi J, Kwon SY, Lee HM, Lee SH, Lee SH (2011) Effectiveness of nasal surgery alone on sleep quality, architecture, position, and sleep-disordered breathing in obstructive sleep apnea syndrome with nasal obstruction. Am J Rhinol Allergy 25:338–341CrossRefPubMed
65.
Sufioglu M, Ozmen OA, Kasapoglu F, Demir UL, Ursavas A, Erisen L, Onart S (2012) The efficacy of nasal surgery in obstructive sleep apnea syndrome: a prospective clinical study. Eur Arch Otorhinolaryngol 269:487–494CrossRefPubMed
66.
Victores AJ, Takashima M (2012) Effects of nasal surgery on the upper airway: A drug-induced sleep endoscopy study. Laryngoscope 122:2606–2610CrossRefPubMed
67.
Hu B, Han D, Li Y, Ye J, Zang H, Wang T (2013) Polysomnographic effect of nasal surgery on positional and non-positional obstructive sleep apnea/hypopnea patients. Acta Otolaryngol 133:858–865CrossRefPubMed
68.
Poirier J, George C, Rotenberg B (2014) The effect of nasal surgery on nasal continuous positive airway pressure compliance. Laryngoscope 124:317–319CrossRefPubMed
69.
Yalamanchali S, Cipta S, Waxman J, Pott T, Joseph N, Friedman M (2014) Effects of endoscopic sinus surgery and nasal surgery in patients with obstructive sleep apnea. Otolaryngol Head Neck Surg 151:171–175CrossRefPubMed
70.
Park CY, Hong JH, Lee JH, Lee KE, Cho HS, Lim SJ, Kwak JW, Kim KS, Kim HJ (2014) Clinical effect of surgical correction for nasal pathology on the treatment of obstructive sleep apnea syndrome. PLOS ONE 9:e98765CrossRefPubMedPubMedCentral
71.
Xiao Y, Han D, Zang H, Wang D (2016) The effectiveness of nasal surgery on psychological symptoms in patients with obstructive sleep apnea and nasal obstruction. Acta Otolaryngol 2016(136):626–632CrossRef
72.
Verse T, Baisch A, Maurer JT, Stuck BA, Hörmann K (2006) Multilevel surgery for obstructive sleep apnea: short-term results. Otolaryngol Head Neck Surg 134:571–577CrossRefPubMed
73.
Li HY, Wang PC, Chen YP, Lee LA, Fang TJ, Lin HC (2011) Critical appraisal and meta-analysis of nasal surgery for obstructive sleep apnea. Am J Rhinol Allergy 25:45–49CrossRefPubMed
74.
Rombaux P, Liistro G, Hamoir M, Bertrand B, Aubert G, Verse T, Rodenstein D (2005) Nasal obstruction and its impact on sleep-related breathing disorders. Rhinology 43:242–250PubMed
75.
76.
Li HY, Lin Y, Chen NH, Lee LA, Fang TJ, Wang PC (2008) Improvement in quality of life after nasal surgery alone for patients with obstructive sleep apnea and nasal obstruction. Arch Otolaryngol Head Neck Surg 134:429–433CrossRefPubMed
77.
Stapleton AL, Chang YF, Soose RJ, Gillman GS (2014) The impact of nasal surgery on sleep quality: a prospective outcome study. Otolaryngol Head Neck Surg 151:868–873CrossRefPubMed
78.
Verse T, Hörmann K (2011) The surgical treatment of sleep-related upper airway obstruction. Dtsch Arztebl Int 108:216–221PubMedPubMedCentral
79.
Mayer-Brix J, Müller-Marschhausen U, Becker H, Peter JH (1989) Wie häufig sind pathologische HNO-Befunde bei Patienten mit obstruktivem Schlaf-Apnoe-Syndrom? HNO 37:511–516PubMed
80.
Dorn M, Pirsig W, Verse T (2001) Postoperatives Management nach rhinochirurgischen Eingriffen bei Patienten mit schwerer obstruktiver Schlafapnoe: eine Pilotstudie. HNO 49:642–645CrossRefPubMed
81.
Masdon JL, Magnuson JS, Youngblood G (2004) The effects of upper airway surgery for obstructive sleep apnea on nasal continuous positive airway pressure settings. Laryngoscope 114:205–207CrossRefPubMed
82.
Zonato AI, Bittencourt LR, Martinho FL, Gregório LC, Tufik S (2006) Upper airway surgery: the effect on nasal continuous positive airway pressure titration on obstructive sleep apnea patients. Eur Arch Otorhinolaryngol 263:481–486CrossRefPubMed
83.
Regli A, von Ungern-Sternberg BS, Strobel WM, Pargger H, Welge-Luessen A, Reber A (2006) The impact of postoperative nasal packing on sleep-disordered breathing and nocturnal oxygen saturation in patients with obstructive sleep apnea syndrome. Anesth Analg 102:615–620CrossRefPubMed
84.
Kezirian EJ, Weaver EM, Yueh B, Khuri SF, Daley J, Henderson WG (2006) Risk factors for serious complication after uvulopalatopharyngoplasty. Arch Otolaryngol Head Neck Surg 132:1091–1098CrossRefPubMed
85.
Morris LG, Setlur J, Burschtin OE, Steward DL, Jacobs JB, Lee KC (2006) Acoustic rhinometry predicts tolerance of nasal continuous positive airway pressure: a pilot study. Am J Rhinol 20:133–137PubMed
86.
Chai CL, Pathinathan A, Smith B (2006) Continuous positive airway pressure delivery interfaces for obstructive sleep apnoea. Cochrane Database Syst Rev 18(4):CD005308
87.
Weaver TE (2006) Adherence to positive airway pressure therapy. Curr Opin Pulm Med 12:409–413CrossRefPubMed
88.
Poirier J, George C, Rotenberg B (2014) The effect of nasal surgery on nasal continuous positive airway pressure compliance. Laryngoscope 124:317–319CrossRefPubMed
89.
Rösslein M, Bürkle H, Walther A, Stuck BA, Verse T (2015) Positionspapier zum perioperativen Management von erwachsenen Patienten mit obstruktiver Schlafapnoe bei HNO-ärztlichen Eingriffen. Laryngorhinootologie 94:516–523CrossRefPubMed
90.
American Society of Anesthesiologists Task Force on Perioperative Management of patients with obstructive sleep apnea (2014) Practice guidelines for the perioperative management of patients with obstructive sleep apnea: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Management of patients with obstructive sleep apnea. Anesthesiology 120:268–286CrossRef
91.
de Araújo MT, Bissoli NS, Gouvêa SA, Pacheco MC, Meyer B, Vasquez EC, Fleury B (2013) CPAP therapy prevents increase in blood pressure after upper airway surgery for obstructive sleep apnoea. Sleep Breath 17(4):1289–1299CrossRefPubMed
92.
Cohen JC, Larrabee YC, Weinstein AL, Stewart MG (2015) Use of continuous positive airway pressure after rhinoplasty, septoplasty, and sinus surgery: A survey of current practice patterns. Laryngoscope 125:2612–2616CrossRefPubMed
Metadaten
Titel
Behandlung der Nasenatmungsbehinderung bei Patienten mit obstruktiver Schlafapnoe
verfasst von
Prof. Dr. med. T. Verse
S. Wenzel
Publikationsdatum
04.11.2016
Verlag
Springer Medizin
Erschienen in
HNO / Ausgabe 2/2017
Print ISSN: 0017-6192
Elektronische ISSN: 1433-0458
DOI
https://doi.org/10.1007/s00106-016-0269-9

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