Nasal Obstruction: Snoring

Nasal Valve Collapse New York Repair

In today’s society, snoring is often treated as a joke. The husband (in most cases) sleeps contentedly and snores like an asthmatic chainsaw, while his wife tosses and turns, her sleep disrupted by her noisy spouse. The fact is that these films, TV shows and comic strips fail to portray that snoring can often be a symptom of much more dangerous health problems, and can lead to other serious issues. For patients with snoring problems, and the partners who try to sleep alongside them, “Nose Jobs” are not just for cosmetic purposes any more. Dr. Slupchynskyj’s Corrective Nasal Valve Collapse Surgery can improve a patient’s quality of life, allowing for everyone to have sweet dreams and optimal nasal function.

What Causes Snoring?

Snoring occurs when air passages are obstructed or narrowed, which inhibits our ability to take deep, full breaths during sleep. Several factors, including age, weight and gender, can contribute to snoring. For instance, as we age, we lose muscle tone in the throat, which leads to a narrowing of the air passages. Also, men snore more frequently than women, due to having narrower air passages. Since narrower passages become blocked more easily, men are more likely to snore than women.

One of the major causes of snoring is obstruction in the airways. In some cases, this congestion can arise from nasal congestion or sinus infections. Many over-the-counter medications are available as remedies for these situations. A more serious type of nasal obstruction can occur when the nose is not shaped properly to allow for adequate airflow. These obstructions, reviewed below, can contribute to other health problems and may require Nasal Surgery to correct them.

Health Risks of Snoring

When obstructions or structural deficiencies in the nose cause snoring, they can also lead to sleep apnea. Sleep apnea occurs when the airways are closed off during sleep. The lack of oxygen can cause severe stress on the heart, lungs, and brain, which can lead to heart attacks and strokes. Also, patients who do not get enough sleep due to snoring also experience more sleepy feelings during the day. The lack of sleep can contribute to mental disorders such as depression, memory loss and lack of concentration.

Causes of Snoring and Treatment

Nasal Valve Collapse

The narrowest part of the nostril passage, known as the nasal valve, acts as the entry point for air traveling from the nose to the lungs. When these valves are blocked at the nostril opening, the condition is called an “External Nasal Valve Collapse.” When the blockage occurs within the nostril, this is called an “Internal Nasal Valve Collapse” A simple method for checking on whether a Nasal Valve Collapse has occurred is to pull the cheek away from the nose on the affected side, a move known as the “Cottle maneuver.” If the airflow through the nose improves after the Cottle maneuver, the patient likely has a collapsed nasal valve.

Causes of Nasal Valve Collapse

As part of the aging process, the cartilage that forms the sidewalls of the nose can lose structural integrity. The loss of cartilage often results in the tip of the nose descending past the base, which can obstruct the air passages and cause an external valve collapse. Also, the sidewalls can experience trauma from a blow, and accident, or from surgery that can result in a weakening of the sidewalls and an internal valve collapse.

Nasal Valve Collapse Treatment

A surgical procedure to correct a Nasal Valve Collapse can both relieve snoring and give the nose a more appealing shape. Dr. Slupchynskyj will often choose which procedure the patient will undergo based on the structure of the nose, the nature of the valve collapse, and several other factors. One of those options is an alar batten graft, a procedure where a piece of cartilage from the nose or ear reinforces the air passageway.

Deviated Septum

Along with the sidewalls of the nose, the cartilage that forms the wall between the nostrils is also vital for maintaining efficient airflow and preventing snoring. When that dividing wall (called the “septum”) becomes crooked or off-center, the air does not flow smoothly through the nostrils. Although up to 80 percent of the population has a septum that is not completely straight, patients with the most severe problems are said to have a “deviated septum.” A deviated septum can also lead to congestion, nosebleeds, headaches and sinus infections.

Causes of Deviated Septum

In rare cases, an infant can be born with a deviated septum, either through a genetic anomaly or by compression on the nose during childbirth. The septum can also change shape during adolescent growth spurts or as part of the aging process as the nasal cartilage loses its strength. In most instances, the septum is knocked off-center due to injury, such as from contact sports or accidental collision.

Septoplasty Surgery to Correct a Deviated Septum

Reconstructive surgery on the septum is called “Septoplasty.” Dr. Slupchynskyj will initially examine the interior of the nostrils with an endoscope to determine the severity of the deviation and the best way to proceed with the surgery. The operation typically takes an hour to an hour and a half, with the patient receiving either Local Anesthesia or twilight sedation.

Septoplasty Surgery involves making accessing the soft tissue lining the nose (also called “mucosa”) and separating the lining from the inner layer of bone and cartilage. The septum then needs to be straightened and realigned.

Turbinate Hypertrophy

Inside the nose, a set of structures filter, warm up, and humidify the air as it flows through the nostrils and into the lungs. These bony structures (called “turbinates”) come in sets of three: inferior, middle and superior. Despite the names, the inferior turbinate is the largest of the three, with the superior being the smallest. When these tissues become enlarged, it can lead to a condition known as “turbinate hypertrophy.” The swelling and infection of the turbinates can also contribute to snoring and other breathing problems.

Causes of Turbinate Hypertrophy

When a patient experiences a sinus infection or nasal congestion, the turbinates can become swollen and irritated. These problems can stem from an upper respiratory infection (such as the “common cold”), flu symptoms or allergies. Users of some prescription medications have also reported experiencing turbinate hypertrophy as a side effect.

Turbinate Hypertrophy Treatment

When the use of over-the-counter medications or other treatments does not return the turbinates to their original size, the patient may consider a surgical procedure to correct the problem. Dr. Slupchynskyj can perform a turbinoplasty procedure, often in conjunction with a septoplasty. In some instances, Dr. Slupchynskyj will remove a portion of the inferior turbinate bone to relieve congestion. In milder cases, the operation involves removing some of the tissue under the protective mucosa layer. This procedure removes the obstruction while preserving the blood vessels that humidify and heat the air.

Nasal Polyps

Patients can often experience the growth of soft, benign tumors inside the sinuses and nasal cavities. These tumors, or nasal polyps, hang down from the roof of the sinuses like stalactites from the ceilings of caves. Nasal polyps are frequently painless and asymptomatic; however, larger polyps can cause obstruction of the nasal passages and lead to snoring and other respiratory problems. Severe blockages can inhibit the patient’s sense of smell and can lead to an increased incidence of nasal infections.

Causes of Nasal Polyps

Nasal polyps can occur in both younger and more mature adults. The polyps frequently appear in the ostiomeatal complex, the area of the sinuses that open into the nasal cavity. The polyps arise from inflammation of the mucous membrane in the nose and sinuses. Allergies, medication, genetic growth disorders like cystic fibrosis, or other respiratory diseases such as asthma can bring about the inflammation that causes polyps, but scientists have yet to pin down any specific trigger that leads to polyp growth.

Surgery to Remove Nasal Polyps

Doctors will often initially recommend medication for the removal of nasal polyps. If the medication proves ineffective, doctor and patient will explore surgical options. An endoscope will be utilized to determine the severity of the blockage, as well as the size, number and extent of the polyps.

A Polypectomy removes smaller polyps with a rotary cutting tool (called a “microdebrider”) specifically designed for sensitive tissue. For more severe cases, Dr. Slupchynskyj may conduct a full endoscopic procedure on the nasal and sinus cavities to remove the polyps and to inhibit future polyp growth.

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