Predictive value of sleep nasendoscopy in the management of habitual snorers

Sleep nasendoscopy (SN) is claimed to identify the site of obstruction in habitual snoring and is used to select patients for palatal surgery. The validity of SN is, however, unproven. This is the first prospective blind assessment of the role of SN in the management of habitual snorers. Fifty-five consecutive patients listed for laser-assisted uvulopalatoplasty (LAUP) for simple snoring on clinical criteria underwent SN immediately before surgery. Snoring severity and Epworth Sleepiness Scales were completed before the operation and at least 3 months after the operation. The postoperative scores on the snoring severity scale had significantly improved after LAUP, for each SN grade: grade 1 (palatal obstruction; p = .04) and grade 2 (multisegmental obstruction; grade 2A, p = .003, and grade 2B, p = .01). The Epworth Sleepiness Scale showed significant improvement in the whole group (p = .02). We conclude that SN grading of sites of pharyngeal collapse is an insufficient basis to exclude patients from LAUP. Sleep nasendoscopy is thus not of value in the management of habitual snoring, as the measure is a poor predictor of favorable outcome after palatal surgery.