Skip to main content
SpringerLink
Log in

HNO-ärztliche Aspekte bei der Diagnostik und Therapie der obstruktiven Schlafapnoe

  • Chapter
Schlafapnoe

  • 77 Accesses

Zusammenfassung

Zwei große Gruppen schlafbezogener Atemstörungen werden unterschieden, nämlich solche mit und ohne Obstruktion der oberen Luftwege. In diesem Beitrag wird nur auf die Gruppe der schlafbezogenen Atemstörungen mit Obstruktionen (OSAS) der oberen Luftwege eingegangen. Ist die Obstruktion partiell, so spricht man vom obstruktiven Schnarchen, ist die Obstruktion komplett (Okklusion), so spricht man von obstruktiver Schlafapnoe (OSA). Da bei beiden Formen Schnarchen zum Leitsymptom gehört, spricht man auch von Rhonchopathien. Schnarchen entsteht durch Einengungen des oberen Luftweges bis zur Glottis. Es ist meist an das Inspirium, selten an das Exspirium oder an beides gekoppelt. Schnarchen ist mit Vibrationen der pharyngealen Wandgewebe assoziiert, und zwar meist des weichen Gaumens und der seitlichen Pharynxwände und weniger häufig des Hypopharynx oder der Epiglottis. Schnarchepisoden hat man ebenfalls nach Lautstärke und Häufigkeit zu quantifizieren versucht, jedoch ist dabei noch weniger eine Standardisierung erreicht worden als bei der Definition der Episoden gestörter Respiration im Schlaf (Apnoe, Hypopnoe, SauerstoffentSättigung). Am häufigsten wird Schnarchen ohne unmittelbare Auswirkungen auf andere Körperfunktionen beobachtet und kann als nichtapnoisches Schnarchen dann lästig für die Umgebung werden. Dagegen kann das krankhafte oder apnoische Schnarchen auch schädigende Auswirkungen auf das kardiopulmonale System und auf die Hirnfunktionen haben. Es gibt inzwischen zahlreiche Hinweise, daß das nichtapnoische Schnarchen nur den Anfang einer Erkrankung darstellt, welche mit zunehmendem Morbiditätsgrad in das andere Extrem übergeht, das durch die ausgeprägteste Form des schweren OSAS repräsentiert wird, nämlich das Pickwick-Syndrom.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 89.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  • Anand VK, Ferguson PW, Schoen LS (1991) Obstructive sleep apnea: a comparison of continuous positive airway pressure and surgical treatment. Otolaryngol Head Neck Surg 105: 382–390

    PubMed  CAS  Google Scholar 

  • Anonymous (1994) Practice parameters for the use of laser-assisted uvulopalatoplasty. Standards of Practice Committee of the American Sleep Disorders Association. Sleep 17: 744–748

    Google Scholar 

  • Atkins M, Taskar V, Clayton N, Stone P, Woodcock A (1994) Nasal resistance in obstructive sleep apnea. Chest 105: 1133–1135

    Article  PubMed  CAS  Google Scholar 

  • Aubert-Tulkens G, Hamoir M, Eeckhaut J van den, Rodenstein DO (1989) Failure of tonsil and nose surgery in adults with long-standing severe sleep apnea syndrome. Arch Intern Med 149: 2118–2121

    Article  PubMed  CAS  Google Scholar 

  • Bernecker F, Stasche N, Hörmann K (1993) Rhonchopathie and Schlafapnoe-Syndrom: Chirurgische Behandlung and MESAM-IV-kontrollierte, postoperative Ergebnisse. Laryngol Rhinol Otol (Stuttg) 72: 398–401

    Article  CAS  Google Scholar 

  • Blakely BW, Mahowald MW (1987) Nasal resistance and sleep apnea. Laryngoscope 97: 752–754

    Google Scholar 

  • Borowiecki B, Pollack CP, Weitzman ED, Rakoff S, Imperato J (1978) Fibro-optic study of pharyngeal airway during sleep in patients with hypersomnia obstructive sleep apnea syndrome. Laryngoscope 88: 1310–1313

    Article  PubMed  CAS  Google Scholar 

  • Bundesausschuß der Ärzte and Krankenkassen (1991) Richtlinien zur Diagnostik and Therapie der Schlafapnoe. Dtsch Ärztebl 88: 2181–2182

    Google Scholar 

  • Caldarelli DD, Cartwright RD, Lilie JK (1985) Obstructive sleep apnea. Variations in surgical management. Laryngoscope 95: 1070–1073

    CAS  Google Scholar 

  • Dantas RO, Dodds WJ, Massey BT, Shaker R, Cook IJ (1990) Manometric characteristics of glossopalatal sphincter. Dig Dis Sci 35: 161–166

    Article  PubMed  CAS  Google Scholar 

  • Dayal VS, Phillipson EA (1985) Nasal surgery in the management of sleep apnea. Ann Otol Rhinol Laryngol 94: 550–554

    PubMed  CAS  Google Scholar 

  • Fairbanks DNF (1985) Effect of nasal surgery on snoring. South Med J 78: 268–270

    Article  PubMed  CAS  Google Scholar 

  • Fairbanks DNF, Fujita S (eds) (1994) Snoring and obstructive sleep apnea. 2. edn. Raven, New York

    Google Scholar 

  • Finkelstein Y, Talmi Y, Zohar Y (1988) Readaptation of the velopharyngeal valve following the uvulopalatopharyngoplasty operation. Plast Reconstr Surg 82: 20–27

    PubMed  CAS  Google Scholar 

  • Fiz JA, Morera J, Abad J, Belsunces A, Haro M, Fiz JI et al. (1993) Acoustic analysis of vowel emission in obstructive sleep apnea. Chest 104: 1093–1096

    Article  PubMed  CAS  Google Scholar 

  • Fletcher EC (1989) Recurrence of sleep apnea syndrome following tracheostomy. A shift from obstructive to central apnea. Chest 96: 205–209

    Article  PubMed  CAS  Google Scholar 

  • Fox AW, Monoson PK, Morgan CD (1989) Speech dysfunction of obstructive sleep apnea. A discriminant analysis of its descriptors. Chest 96: 589–595

    Article  PubMed  CAS  Google Scholar 

  • Freed G, Pearlman MA, Brown SA (1988) Polysomnographic indications for surgical intervention in Pierre Robin sequence: Acute airway management and follow-up studies after repair and take-down of tongue-lip adhesion. Cleft Palate J. 25: 151–155

    PubMed  CAS  Google Scholar 

  • Fujita S, Conway W, Zorick F (1981) Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 89: 923–934

    PubMed  CAS  Google Scholar 

  • Gillespie MB, Flint PW, Smith PL, Eisele DW, Schwartz AR (1995) Diagnosis and treatment of obstructive sleep apnea of the larynx. Arch Otolaryngol Head Neck Surg 121: 335–339

    Article  PubMed  CAS  Google Scholar 

  • Gislason T, Lindholm CE, Almqvist M, Birring E, Boman G, Eriksson G, Larsson S, Lidell C, Svanholm H (1988) Uvulopalatopharyngoplasty in the sleep apnea syndrome–predictors of results. Arch Otolaryngol Head Neck Surg 114: 45–51

    Article  PubMed  CAS  Google Scholar 

  • Guilleminault C (1990) Treatments in obstructive sleep apnea. In Guilleminault C, Partinen M (eds) Obstructive sleep apnea syndrome: Clinical research and treatment. Raven, New York, pp 99–118

    Google Scholar 

  • Guilleminault C, Korobkin R, Winkle R (1981) A review of 50 children with obstructive sleep apnea syndrome. Lung 159: 275–287

    Article  PubMed  CAS  Google Scholar 

  • Guilleminault C, Simmons FB, Motta J, Cummiskey J, Rosekind M, Schroeder JS, Dement WC (1981) Obstructive sleep apnea syndrome and tracheostomy: long-term follow-up experience. Arch Intern Med 141: 985–989

    Article  PubMed  CAS  Google Scholar 

  • Hasan A, McGuigan J, Morgan MDL, Matthews HR (1989) Minitracheotomy: a simple alternative to tracheostomy in obstructive sleep apnoea. Thorax 44: 224–225

    Article  PubMed  CAS  Google Scholar 

  • He J, Kryger MH, Zorick FJ, Conway W, Roth T (1988) Mortality and apnea index in obstructive sleep apnea: Experience in 385 male patients. Chest 94: 9–14

    Article  PubMed  CAS  Google Scholar 

  • Hochban W (1995) Das obstruktive Schlafapnoesyndrom. Blackwell, Berl in Wien

    Google Scholar 

  • Hoffstein V, Chaban R, Cole P, Rubinstein I (1988) Snoring and upper airway properties. Chest 94: 87–89

    Article  PubMed  CAS  Google Scholar 

  • Hoffstein V, Mateika S, Metes A (1993) Effect of nasal dilation on snoring and apneas during different stages of sleep. Sleep 16: 360–336

    PubMed  CAS  Google Scholar 

  • Höijer U, Ejnell H, Hedner J, Petruson B, Eng LB (1992) The effects of nasal dilation on snoring and obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 118: 281–284

    Article  PubMed  Google Scholar 

  • Hudgel DW, Hendricks C (1988) Palate and hypopharynx: Sites of inspiratory narrowing of the upper airway during sleep. Am Rev Respir Dis 138: 1542–1547

    Article  PubMed  CAS  Google Scholar 

  • Hudgel DW, Robertson DW (1984) Nasal resistance during wakefulness and sleep in normal man. Acta Otolaryngol (Stockh) 98: 130–135

    Article  CAS  Google Scholar 

  • Jamieson A, Guilleminault C, Partinen M, Quera-Salva MA (1986) Obstructive sleep apneic patients have craniomandibular abnormalities. Sleep 9: 469–477

    PubMed  CAS  Google Scholar 

  • Johannessen N, Jensen PF, Kristensen S, Juul A (1992) Nasal packing and nocturnal oxygen desaturation. Acta Otolaryngol (Stockh) 492 [Suppl]: 6–8

    Article  CAS  Google Scholar 

  • Kapuniai LE, Andrew DJ, Cromwell DH, Pearce JW (1988) Identifying sleep apnea from self-reports. Sleep 11: 430–436

    PubMed  CAS  Google Scholar 

  • Katsantonis GP, Schweitzer PK, Branham GH, Chambers G, Walsh JK (1988) Management of obstructive sleep apnea: Comparison of various treatment modalities. Laryngoscope 98: 304–309

    PubMed  CAS  Google Scholar 

  • Keenan SP, Burt H, Ryan CF, Fleetham JA (1994) Long-term survival of patients with obstructive sleep apnea treated by uvulopalatopharyngoplasty or nasal CPAP. Chest 105: 155–159

    Article  PubMed  CAS  Google Scholar 

  • Kerr P, Millar T, Buckle P, Kryger M (1992) The importance of nasal resistance in obstructivesleep apnea syndrome. J Otolaryngol 21: 189–195

    PubMed  CAS  Google Scholar 

  • Kravath RE, Pollak CP, Borowiecki B (1977) Hypoventilation during sleep in children who have lymphoid airway obstruction treated by nasopharyngeal tube and T and A. Pediatrics 59: 865–871

    CAS  Google Scholar 

  • Kribbs NB, Pack AI, Kline LR, Smith PL, Schwartz AR, Schubert NM, Redline S, Henry JN, Getsy JE, Dinges DF (1993) Objective measurements of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis 147: 887–895

    PubMed  CAS  Google Scholar 

  • Kuehn DP, Templeton PJ, Maynard JA (1990) Muscle spindles in the velopharyngeal musculature of humans. J Speech Hear Res 33: 488–493

    PubMed  CAS  Google Scholar 

  • Kuhlo WE, Doll E, Franck C (1969) Erfolgreiche Behandlung eines Pickwick-Syndroms durch Dauertrachealkanüle. Dtsch Med Wochenschr 94: 1268–1290

    Article  Google Scholar 

  • Larsson LH, Carlsson-Nordlander B, Svanborg E (1994) Four-year follow-up after uvulopalatopharyngoplasty in 50 unselected patients with obstructive sleep apnea syndrome. Laryngoscope 104: 1362–1368

    Article  PubMed  CAS  Google Scholar 

  • Launois SH, Feroah TR, Campbell WN, Whitelaw WA, Remmers JE (1990) Site of obstruction in obstructive sleep apnea: influence on the outcome of uvulopalatopharyngoplasty. Am Rev Respir Dis 141: 861

    Google Scholar 

  • Launois SH, Feroah TR, Campbell WN, Issa FG, Morrison D, Whitelaw A, Isono S, Remmers JE (1993) Site of pharyngeal narrowing predicts outcome of surgery for obstructive sleep apnea. Am Rev Respir Dis 147: 182–189

    Article  PubMed  CAS  Google Scholar 

  • Lavie P, Rubin AE (1984) Effects of nasal occlusion on respiration in sleep. Evidence of inheritability of sleep apnea proneness. Acta Otolaryngol (Stockh) 97: 127–130

    Article  CAS  Google Scholar 

  • Lavie P, Fischel N, Zomer J, Eliaschar I (1983) The effects of partial and complete mechanical occlusion of the nasal passages on sleep structure and breathing in sleep. Acta Otolaryngol (Stockh) 95: 161–166

    Article  CAS  Google Scholar 

  • Ledereich PS, Thorpy MJ, Glovinsky PK, Burack B, McGregor P et al. (1988) Five year follow-up of daytime sleepiness and snoring after tracheostomy in patients with obstructive sleep apneas. In: Chouard C (ed) Chronic rhonchopathy. Libbey Eurotext, London, pp 354–357

    Google Scholar 

  • Lenders H, Pirsig W (1992) Acoustic rhinometry: a diagnostic tool for patients with chronic rhonchopathies. Rhinology 14 [Suppl]: 101–105

    CAS  Google Scholar 

  • Lenders H, Schäfer J, Pirsig W (1991) Turbinate hypertrophy in habitual snorers and patients with obstructive sleep apnea: findings of acoustic rhinometry. Laryngoscope 101: 614–618

    Article  PubMed  CAS  Google Scholar 

  • Macaluso RA, Reams C, Gibson WS, Vrabec DP, Matragrano A (1989) Uvulopalatopharyngoplasty: postoperative management and evaluation of results. Ann Otol Rhinol Laryngol 98: 502–507

    PubMed  CAS  Google Scholar 

  • Marcus CL, McColley SA, Carroll JL, Loughlin GM, Smith PL, Schwartz AR (1994) Upper airway collapsibility in children with obstructive sleep apnea syndrome. J Appl Physiol 77: 918–924

    PubMed  CAS  Google Scholar 

  • Mayer-Brix J, Becker H, Peter JH (1989) Nasale Überdruckbeatmung bei obstruktivem Schlaf-Apnoe-Syndrom. Theoretische and praktisch hals-nasen-ohrenärztliche Aspekte. Laryngol Rhinol Otol (Stuttg) 68: 295–298

    Article  CAS  Google Scholar 

  • McNicholas WT, Tarlo S, Cole P, Zamel N, Rutherford R, Griffin D, Phillipson EA (1982) Obstructive apneas during sleep in patients with seasonal allergic rhinitis. Am Rev Respir Dis 126: 625–628

    PubMed  CAS  Google Scholar 

  • Metes A, Cole P, Hoffstein V, Miljeteig H (1992) Nasal airway dilation and obstructed breathing in sleep. Laryngoscope 102: 1053–1055

    Article  PubMed  CAS  Google Scholar 

  • Meurice JC, Dore P, Paquereau J, Neau JP, Ingrand P, Chavagnat JJ, Patte F (1994) Predictive factors of long-term compliance with nasal continuous positive airway pressure treatment in sleep apnea syndrome. Chest 105: 429–433

    Article  PubMed  CAS  Google Scholar 

  • Miljeteig H, Hoffstein V, Cole P (1992) The effect of unilateral and bilateral nasal obstruction on snoring and sleep apnea. Laryngoscope 102: 1150–1152

    Article  PubMed  CAS  Google Scholar 

  • Miljeteig H, Savard P, Mateika S, Haight JS, Cole P, Hoffstein V (1993) Snoring and nasal resistance during sleep. Laryngoscope 103: 918–923

    Article  PubMed  CAS  Google Scholar 

  • Miljeteig H, Cole P, Haight SJ (1995) Nasal resistance in recumbancy and sleep. Rhinology 33: 82–83

    PubMed  CAS  Google Scholar 

  • Nahmias JS, Karetzky MS (1988) Treatment of the obstructive sleep apnea syndrome using a nasopharyngeal tube. Chest 94: 1142–1147

    Article  PubMed  CAS  Google Scholar 

  • Olsen KD, Kern EB, Westbrook PR (1981) Sleep and breathing disturbance secondary to nasal obstruction. Otolaryngol Head Neck Surg 89: 804–810

    PubMed  CAS  Google Scholar 

  • Paditz E (1994) Nächtliche nasale Maskenbeatmung im Kindesalter. Pneumologie 48: 744–749

    PubMed  CAS  Google Scholar 

  • Park SS (1993) Flow-regulatory function of upper airway in health and disease: A unified pathogenetic view of sleep-disordered breathing. Lung 171: 311–333

    Article  PubMed  CAS  Google Scholar 

  • Petruson B (1988) Improvement of the nasal airflow by the nasal dilator Nozovent. Rhinology 26: 289–292

    PubMed  CAS  Google Scholar 

  • Pirsig W (1995) Diagnostik der Schlafapnoe. HNO 43: 333–335

    PubMed  CAS  Google Scholar 

  • Pirsig W (1997) Obstructive sleep apnea. In: McCaffrey Th (ed) Rhinologic diagnosis and treatment. Thieme, New York, pp 229–269

    Google Scholar 

  • Pirsig W, Schäfer J, Yildiz F, Nagel J (1989) Uvulopalatopharyngoplastik ohne Komplikationen: eine Modifikation nach Fujita. Laryngol Rhinol Otol (Stuttg) 68: 585–590

    Article  CAS  Google Scholar 

  • Polo O, Brissaud L, Fraga J, Dejean Y, Billiard M (1989) Partial upper airway obstruction in sleep after uvulopalatopharyngoplasty. Arch Otolaryngol Head Neck Surg 115: 1350–1354

    Article  PubMed  CAS  Google Scholar 

  • Reeves-Hoche MK, Meck R, Zwillich CW (1994) Nasal CPAP an objective evaluation of patient compliance. Am J Respir Crit Care Med 149: 149–154

    PubMed  CAS  Google Scholar 

  • Remmers JE, de Groot WJ, Sauerland EK, Anch AM (1978) Pathogenesis of upper airway occlusion during sleep. J Appl Physiol 44: 931–938

    PubMed  CAS  Google Scholar 

  • Riley R, Guilleminault C, Herran J, Powell N (1983) Cephalometric analyses and flow volume loops in obstructive sleep apnea. Sleep 6: 303–311

    PubMed  CAS  Google Scholar 

  • Riley RW, Powell NB, Guilleminault C (1993) Obstructive sleep apnea syndrome: a review of 306 consecutively treated surgical patients. Otolaryngol Head Neck Surg 108: 117–125

    PubMed  CAS  Google Scholar 

  • Ripberger R, Pirsig W (1994) Die nasale Überdruckbeatmung (nCPAP) zur Therapie der obstruktiven Schlafapnoe. Laryngol Rhinol Otol (Stuttg) 73: 581–585

    Article  CAS  Google Scholar 

  • Rivlin J, Hoffstein V, Kalbfleisch J, McNicholas W, Zamel N, Bryan AC (1984) Upper airway morphology in patients with idiopathic obstructive sleep apnea. Am Rev Respir Dis 129: 355–360

    PubMed  CAS  Google Scholar 

  • Rosenfeld RM, Green RP (1990) Tonsillectomy and adenoidectomy: changing trends. Ann Otol Rhinol Laryngol 99: 187–191

    PubMed  CAS  Google Scholar 

  • Rubin AHE, Eliaschar I, Joachim Z, Alroy G, Lavie P (1983) Effects of nasal surgery and tonsillectomy on sleep apnea. Bull Eur Physiopathol Respir 19: 612–615

    PubMed  CAS  Google Scholar 

  • Sauerland EK, Orr WC, Hairston LE (1981) EMG patterns of oropharyngeal muscles during respiration in wakefulness and sleep. Electromyogr Clin Neurophysiol 21: 307–316

    PubMed  CAS  Google Scholar 

  • Schäfer J (1989) Wie erkennt man einen Velumschnarcher? Laryngol Rhinol Otol 68: 290–295

    Article  Google Scholar 

  • Schäfer J (1993) Surgery of the upper airway - can surgical outcome be predicted? Sleep 16 [Suppl 8]: S98 - S99

    PubMed  Google Scholar 

  • Schwartz AR, Smith PL, Wise RA, Gold AR, Permutt S (1988) Induction of upper airway occlusion in sleeping individuals with subatmospheric nasal pressure. J Appl Physiol 64: 535–542

    PubMed  CAS  Google Scholar 

  • Schwartz AR, Schubert N, Rothman W, Godley F, Marsh B, Eisele, Nadeau J, Permutt L, Gleadhill I, Smith PL (1992) Effect of uvulopalatopharyngoplasty on upper airway collapsibility obstructive sleep apnea. Am Rev Respir Dis 145: 527–532

    PubMed  CAS  Google Scholar 

  • Series F, Pierre SS, Carrier G (1992) Effects of surgical correction of nasal obstruction in the treatment of obstructive sleep apnea. Am Rev Respir Dis 146: 1261–1265

    PubMed  CAS  Google Scholar 

  • Series F, Mark I, Atton L (1993) Comparison of snoring measured at home and during polysomnographic studies. Chest 103: 1769–1773

    Article  PubMed  CAS  Google Scholar 

  • Series F, Pierre SS, Carrier G (1993) Surgical correction of nasal obstruction in the treatment of mild sleep apnoea: importance of cephalometry in predicting outcome. Thorax 48: 360–363

    Article  PubMed  CAS  Google Scholar 

  • Shepard JW jr, Gefter WB, Guilleminault C, Hoffman EA, Hoffstein V, Hudgel DW, Suratt PM, White DP (1991) Evaluation of the upper airway in patients with obstructive sleep apnea. Sleep 14: 361–371

    PubMed  Google Scholar 

  • Smith PL, Wise RA, Gold AR, Schwartz AR, Permutt S (1988) Upper airway pressure-flow relationship in obstructive sleep apnea. J Appl Physiol 64: 789–795

    PubMed  CAS  Google Scholar 

  • Solow B, Tallgren A (1976) Head posture and craniofacial morphology. Am J Phys Anthrop 44: 417–435

    Article  PubMed  CAS  Google Scholar 

  • Stevenson EW, Turner GT, Sutton FD, Doekel RC, Pegram V, Hernandez J (1990) Prognostic significance of age and tonsillectomy in uvulopalatopharyngoplasty. Laryngoscope 100: 820–823

    Article  PubMed  CAS  Google Scholar 

  • Suen JS, Arnold JE, Brooks LJ (1995) Adenotonsillectomy for treatment of obstructive sleep apnea in children. Arch Otolaryngol Head Neck Surg 121: 525–530

    Article  PubMed  CAS  Google Scholar 

  • Sullivan CE, Issa FG, Berthon-Jones M, Eves L (1981) Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet I: 862–865

    Article  Google Scholar 

  • Suratt PM, Turner BL, Wilhoit SC (1986) Effect of intranasal obstruction on breathing during sleep. Chest 90: 324–329

    Article  PubMed  CAS  Google Scholar 

  • Taasan V, Wynne JW, Cassisi N, Block AJ (1981) The effect of nasal packing on sleep-disordered breathing and nocturnal oxygen desaturation. Laryngoscope 91: 1163–1172

    Article  PubMed  CAS  Google Scholar 

  • Tanaka Y, Honda Y (1989) Nasal obstruction as a cause of reduced PCO2 and disordered breathing during sleep. J Appl Physiol 67: 970–972

    PubMed  CAS  Google Scholar 

  • Viner S, Szalai JP, Hoffstein V (1991) Are history and physical examination a good screening test for sleep apnea? Ann Int Med 115: 356–359

    PubMed  CAS  Google Scholar 

  • Wetmore SJ, Scrima L, Hiller FC (1988) Sleep apnea in epitaxis patients treated with nasal packs. Otolaryngol Head Neck Surg 98: 596–599

    PubMed  CAS  Google Scholar 

  • Wilhoit SC, Suratt PM (1987) Effect of nasal obstruction on upper airway muscle activation in normal subjects. Chest 92: 1053–1055

    Article  PubMed  CAS  Google Scholar 

  • Woodson BT, Fujita S (1994) Laser midline glossectomy and lingualplasty for obstructive sleep apnea. In: Fairbanks DNF, Fujita S (eds) Snoring and obstructive sleep apnea. Raven, New York, pp 163–168

    Google Scholar 

  • Zwillich CW, Pickett C, Hanson FN, Weil JV (1981) Disturbed sleep and prolonged apnea during nasal obstruction in normal men. Am Rev Respir Dis 124: 158–160

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. W. Pirsig
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Lenders
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Ruhrlandklinik Abteilung Pneumologie, Universitätsklinik, Tüschener Weg 40, D-45239, Essen, Deutschland

    Nikolaus Konietzko  & Helmut Teschler  & 

  2. Lungenklinik Hemer, D-58675, Hemer, Deutschland

    Lutz Freitag

Rights and permissions

Reprints and permissions

Copyright information

© 1998 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Pirsig, W., Lenders, H. (1998). HNO-ärztliche Aspekte bei der Diagnostik und Therapie der obstruktiven Schlafapnoe. In: Konietzko, N., Teschler, H., Freitag, L. (eds) Schlafapnoe. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58815-0_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-58815-0_10

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-60266-8

  • Online ISBN: 978-3-642-58815-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation