ABSTRACT
Objective: The role of the nose and its importance in the development and severity
of sleep-disordered breathing (SDB) is still a matter of discussion. In the first
part of this study, often-controversial data and theories about the nose are reviewed
concerning its influence on the pathophysiology of SDB and to interpret certain clinical
findings connected with impaired nasal breathing. In the second part, the effectiveness
of some nonsurgical and surgical therapies is evaluated. Method: A worldwide literature
research (Medline) was the basis for this review. Results: The study of the literature
on nasal resistance and clinical findings about the effects of incomplete or complete
nasal blockage, particularly in comparison of healthy persons and persons with SDB,
allows the assumption of the existence of two different groups of responders: a larger
group where the importance of the nose for SDB is negligible and a smaller group where
the influence of the nose on SDB is crucial. The same seems to hold true for the responses
to nonsurgical and surgical treatments with only a few surgical results available
in the literature. While the success rate of nasal surgery for patients with obstructive
sleep apnea, for instance, seems to be less than 20%, the normalization of nasal resistance
often leads to a positive impact on the well-being and the sleep quality of these
patients. However, because criteria to identify responders are lacking, the prediction
of success of any treatment for the individual with SDB is not possible.
KEYWORDS
Rhinosurgery - treatment - nose - pathophysiology - sleep apnea - snoring
