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Nose Surgery: Snoring & Nose Woes

"A wife is wide awake and angry over her husband's snoring"
Before Rhinoplasty?

Hopefully, female eyes will find this post — women are usually the sleep-deprived victims of a loudly snoring man.

Because we concentrate on reconstructive and cosmetic nasal surgery, we see many guys who come in for a rhinoplasty consultation. About half mention their snoring and ask if anything can be done during a nose job procedure to stifle the snoring.

Actually, a handful of conditions cause snoring but allow us to mention what happens just in the nose to cause the nighty log sawing.

The most common situation is a blockage in the upper nose caused by:

  • A once broken nose
  • Being born with a twisted nose
  •     “     sensitive to allergies
  • A bent, twisted or deviated septum

(The septum is the eggshell-thin partition of bone and cartilage between the nostrils.)

Because insufficient air travels through the nose and into the lungs while sleeping on the back, a patient must breathe through his mouth. The racket of snoring comes from tissues in the mouth flopping around with the airflow, sometimes stopping it.

The basic concept: “Healthy breathing is quiet; abnormal breathing is noisy.”

The mouth breathing of snoring also defeats three important nasal functions: warming, filtering and humidifying the air you breathe.

Snoring not only deprives care-worn mates of rest, it also deprives the snorer’s organs of healthy oxygen levels. Results? Daytime sleepiness, grogginess, low alert levels and, usually, falling asleep early in front of the TV.

Two other things can also stifle quiet healthy breathing: nasal polyps and enlarged turbinates, structures higher up in the nose that perform the warming, filtering and humidifying tasks.

Often, the turbinates react badly to allergies and swell, again blocking one or both breathing channels.

However, the news is far from all bad. Whatever the cause of the nasal blockage, an outpatient surgery can usually cure or greatly improve the condition, silencing the snoring.

To start, an exam of the nose, sinuses, throat and neck by a specialist in head and neck surgery is required.

In our practice, about half of cosmetic patients have breathing woes. Happily (and economically!) that functional surgery can be done in the same surgical session as a rhinoplasty.

Some find relief in deviated septum surgery.

Quipped a happy patient: “Doctor, you took my nose from a country lane to a four-lane super highway.”

Rhinoplasty & Snoring

"A wife is wide awake and angry over her husband's snoring"
Before Rhinoplasty?

Snoring is often the stuff of which cartoons are made.

How many times have you seen an artist’s clever vision of snoring, including:

  • Window shades flapping in and out
  • A bedroom filled with giant Z-Z-Z-Z-Z-Z’S
  • A care-worn wife dashing screaming from the room, her hands clamped over her ears

But there’s nothing funny about snoring — it’s actually some very loud bad health in progress.

We note that because, in our practice, about half the patients coming in for cosmetic plastic surgery have breathing problems

Causes of snoring can be many, but you must be wondering what has snoring to do with the nose job procedure?

Simple answer: many snoring cases are abated or cured in connection with rhinoplasty.

Deeper answer: Before rhinoplasty,  the savvy nasal surgeon will examine the nose’s insides for blockages if the patient (or patient’s wife!) reports habitual snoring. The exam is a thorough look-see by a surgeon trained and experienced in head and neck surgery.

The surgeon best qualified to perform that inside the nose exam is also usually board-certified in otolargyngology.

(Read our post about plastic surgery’s board certifications.)

That surgeon thoroughly checks the inside of the nose because some conditions could exist which require a separate surgery before the patient can proceed on to the cosmetic rhinoplasty.

Internal nose passages include:

  • The septum – that thin wall of cartilage separating the nostrils. A septum could be bent, twisted or blocked
  • The turbinates, larger structures farther up in the nose, could require reduction because they sometimes swell
  • Untreated broken noses that healed on their own

Turbinates humidify, filter and warm air before it reaches the lungs. If you snore, you become a mouth breather and get second choice air. Lungs are healthier with nose breathing.

Another answer to snoring may also be found in the sinuses, throat or neck when polyps or allergies are discovered.

In some cases, the patient’s uvula, that dangling structure in the very back of the throat, hangs too far down into the throat and flaps back and forth, causing the sleep robbing Z-z-z-z-zs.

An enlarged adenoid can be the bugbear, especially in children.

But, of those many adult patients who come in with snoring problems, most are totally cured or significantly reduced.

Bottom line: healthy breathing is quiet breathing!