Der Einfluss von funktioneller Rhinochirurgie bei bestehender Nasenpathologie auf die Verbesserung der Maskentoleranz bei Patienten mit obstruktivem Schlafapnoe-Syndrom
Dissertation
Faculties
Medizinische FakultätAbstract
Objective: The CPAP therapy is the gold standard in treating OSA. However, long-term compliance is severely limited in patients with obstructive nasal breathing. This study investigated the possibility of improving mask compliance aided by functional rhinosurgery (FR).
Material: 49 patients with obstructive nasal pathologies were retrospectively examined. 25 received FR (group A), 24 served as control (group B). Parameters evaluated pre- and post-operatively were: ventilation pressure, wearing time and rhinomanometry. Additionally the Beck Depression Inventory (BDI) and Epworth-Sleepiness-Scale (ESS) assessed the quality of life.
Results: The average ventilation pressure before surgery was 10,08 mbar (± 3,7) and post-op 9,08 mbar (± 3.2) (p = 0.019). Group B vs. A pre-op showed no significant differences (p = 0.122), compared to post-op values which were statistically highly significant (p = 0.006).
Wearing time was 3.48 nights per week and increased post-op to 6.32, which was highly significant (p < 0.001). The control group wore the mask only 3.48 h/night. The rhinomanometry improved signififcantly from 402.79 cm3/s to post-op 634.24 cm3/s (p = 0.006). In group B the average was 503,50 cm3/s. No statistical difference between group A pre-op vs. B (p = 0.058) and highly significant after surgery (p < 0.001).
The BDI pre-op was 9.88 and decreased post-op to 6.33 (p = 0.52). In group B it was 5.7 ± 4,9. After surgery, there was no statistical difference between groups A and B (p = 0.49). The Epworth-Sleepiness-Scale (ESS) improved from pre-op 11,05 to post-op significantly to 7.46 (p = 0.004). In group B it was 6.39. Group A post-op compared to group B showed no statistical significant difference (p = 0.345).
Conclusion: In patients with nasal breathing pathologies and OSA, FR can decrease significantly ventilation pressure, prolong wearing time, decrease rhinomanometry and improve subjective therapy success with significantly improved compliance.
Date created
2015
Subject headings
[GND]: Nasenchirurgie | Schlafapnoe[MeSH]: Compliance
[Free subject headings]: OSAS | Rhinochirurgie
[DDC subject group]: DDC 610 / Medicine & health
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Please use this identifier to cite or link to this item: http://dx.doi.org/10.18725/OPARU-3656
Oberhansl, Fabienne (2015): Der Einfluss von funktioneller Rhinochirurgie bei bestehender Nasenpathologie auf die Verbesserung der Maskentoleranz bei Patienten mit obstruktivem Schlafapnoe-Syndrom. Open Access Repositorium der Universität Ulm und Technischen Hochschule Ulm. Dissertation. http://dx.doi.org/10.18725/OPARU-3656
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