Effect of nasal valve surgery by open-septorhinoplasty and lateral cartilage grafts (spreader grafts) on snoring among a population of single snorers. Preliminary report.

Abstract

Snoring is traditionally considered more of a social nuisance than disease. The observation that nasal obstruction may modify breathing during sleep and daytime behavior and our clinical observations suggesting that some single snorer patients who had undergone surgery of the nasal valve for nasal obstruction complaints had presented a decrease in their snoring, led us to make a retrospective study on twenty nine patients. Eight of them were simple snorers. They underwent a surgery of the nasal valve under general anesthesia through an open septorhinoplasty during which lateral graft cartilages (modified spreader grafts) were set in place between septolateral cartilage and the anterior and superior edge of the nasal septum. Active anterior rhinomanometry (AAR), posterior active rhinomanometry (PAR) and a self-assessment of the nasal patency by the patient himself on a visual analog scale (VAS) were compared before and one year after surgery. Snoring was assessed by both bed partners according to a four step scale (none, slight, moderate and severe). No significant differences were found between AAR or between PAR. But significant differences were measured with VAS (for the left (p < 0.0001) and the right sides (p < 0.001). All patients but one demonstrated substantially decreased snoring. As there is no clear cut evidence of changes in nasal resistances measured by rhinomanometry, we suggest that the observed decrease in snoring may be induced by changes in the direction of the nasal airflow against the nasal mucosa which may produce by a reflex between mecanoreceptors of the nasal mucosa and muscles of the pharynx, an increased tonus of the muscles of the pharynx