Surgical Proceduresphase I Nasal Reconstruction

Nasal obstruction can occur due to incompetent nasal valves, septal deviations or chronically enlarged turbinates. A patent nasal airway is essential for normal respiration and sleep. Obstruction can increase airway resistance and result in mouth breathing. Opening of the mouth rotates the mandible posteriorly and inferiorly, which in turn causes the tongue to prolapse into the posterior airway space. A plethora of techniques (septoplasty, alar grafting, and turbinate reduction) exist to treat nasal obstruction. These techniques and their results have been well established in the head and neck literature. The choice of procedure depends upon surgeon preference and experience.

Nasal reconstruction can improve quality of life and may improve OSA in select patients (52,53). In addition, improvement of the nasal airway may improve a patient's tolerance of nasal CPAP (54). Rarely, however, will alleviating nasal obstruction cure OSA.

Although most treatments of the nasal cavity are well established, treatment of the turbinates is an evolving technique. Our preferred method is submucosal tur-binoplasty with a radiofrequency probe. Submucosal turbinoplasty can be performed with radiofrequency or a microdebrider. Radiofrequency is rarely associated with complications such as bleeding or crusting. However, the ultimate goal of reducing submucosal erectile tissue, while preserving the ciliated, surface mucosa is the same (55,56).

Sleep Apnea

Sleep Apnea

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