Diagnosis of snore is characterized by a multidisciplinary approach and along with the questionnaire survey includes the use of complex instrumental procedures. Radiology, in particular the cone-beam computed tomography of the maxillofacial area, allows not only to assess the pathology from the part of the dentofacial system, the paranasal sinuses, the upper airways, but also through preliminary contrast to perform morphometry of structures directly interested in the development of the acoustical phenomenon, which improves the quality of diagnosis and allows to select a high-quality adequate treatment of snore.

OBJECTIVE

To assess the possibility of using computed tomography of the maxillofacial area with preliminary contrast of soft-tissue structures of the throat in the diagnosis and planning of surgical treatment of rhonchopathy.

PATIENTS AND METHODS

A number of patients equal 181 with complaints of snore were examined. All patients included in the study underwent history taking, examination of ENT-organs; sleep evaluation (cardiorespiratory monitoring/stationary polysomnography); determination of body mass index; computed tomography of the maxillofacial area with contrast of soft palate, as a result of which length, thickness of soft palate, palatine uvula. Patients of the 1st group were treated with nonresective laser-assisted uvulopalatoplasty (LAUPP) by method of a contact pinpoint laser exposure. Patients of the 2nd group were treated with nonresective LAUPP by method of interstitial laser exposure on soft palate, pillars of the fauces.

RESULTS

The groups were comparable in age, male sex dominated. In the 1st study group the mean volume of snore decreased from 51.6 to 35.8 dB after LAUPP, the length of the soft palate+the length of the palatine uvula after nonresective LAUPP by method of a contact pinpoint laser exposure decreased by 4 mm (from 38.8 to 34.5 mm), thus the thickness — from 7.7 to 6.4 mm (p<0.05). It has been found that the relative difference of the average proportion of snore was more than 30% (absolute — 16.7 dB (p<0.05)) when comparing the results of the acoustic analysis of snore in the 2nd group. The length of the soft palate+the length of the palatine uvula statistically significantly decreased after 1.5 months after interstitial LAUPP — on average by 10% (4.6 mm), and thickness — by 16.1% (1.5 mm). A strong correlation between the reduction of the length of the soft palate+the palatine uvula and satisfaction with the results of treatment after 1.5 months (r=0.608) has been observed, as well as a statistically significant relationship between the reduction in the length, thickness of the soft palate and the decrease in the volume, duration of snore has been found.

CONCLUSION

Computed tomography of the maxillofacial area with preliminary contrast of soft-tissue structures of the throat allows not only to exclude the presence of pathology from the side of the paranasal sinuses, dentofacial system, but also to identify possible anatomical structures involved in the formation of the acoustical phenomenon of snore, and to assess the risk of obstructive sleep apnoea syndrome presence.