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Health
A Continuous
Positive Airway
Pressure (CPAP)
trial, which is
conducted for seven
days, is the Gold
Standard of OSA
treatment. Patients
who are comfortable
with the treatment
are able to purchase
the machine for
their usage at home.
KKLIU No. 2118/2016
Dr Mohd Zabri Affendi Muhamad
Consultant ENT and Head & Neck Surgeon,
KPJ Selangor Specialist Hospital.
A physical examination will then be conducted around head and
neck region along with a general examination. The specialist will
look for features that can increase the risk of OSA, for instance, a
short, thick and high neck circumference, craniofacial abnormali-
ties, as well as a receeding chin. The Body Mass Index (BMI) will
be calculated, as the higher the BMI, the more complicated the
case will be and the OSA more severe.
A Nasoendoscopy procedure helps to assess the nature of
the nose and immediately detects any abnormalities like septum
deviation and presence of polyps. Flexible Nasopharyngolaryn-
goscopy, on the other hand, asses the larynx, lateral pharynx
and velo pharynx, as an obstruction can occur at multiple levels.
The doctor will also perform Muller’s maneuver, which is done by
asking the patients to breathe and inspire the air with nose shut
to see the possible collapse of airway. The final step is a sleep
study which determines the severity of the OSA by performing a
polysonography. This is to dertermine AHI, oxygen desturations
and snoring patterns.
The Treatment
The treatment for OSA is highly individualised. The
patient either requires surgery or Positive Airway
Pressure Machine treatment (PAPM), which opens
the collapsed airwaves. The Gold standard of OSA
treatment is the PAP treatment, while surgery can
be performed in selected cases.
Surgery will be the treatment of choice for
those who have obstructive features like enlarged
tonsils, bulky soft palate and nasal polyps. The type
of surgery depends on the condition, from general
procedure like Septoplasty and Adenotonsillar to
a more specific procedure like modified cautery-
assisted palatal stiffening operation (CAPSO).
However, the success of surgery depends on the
patient’s physical state as well. Surgery conducted
on those with a BMI of more than 40 will face less
chance of success.
All these treatments are available at KPJ Selan-
gor, where sleep surgery as well as in house sleep
studies and CPAP trials are conducted.Tests can also
be done at a patient’s home with a Continuous Posi-
tive Airway Pressure (CPAP) trial, which is conducted
for seven days. Patients who are comfortable with
the treatment are able to purchase the machine for
their usage at home.
OSA is a chronic disease. It is a slow silent killer.
It might seem like nothing in the beginning but as
it progresses, OSA will the sufferer neurologically,
physically and mentally. The hospital strongly urges
anyone with the symptoms to get themselves tested
as soon as possible.
KPJ Selangor Specialist Hospital
Lot 1, Jalan Singa 20/1, Section 20,
40300 Shah Alam, Selangor.
Tel: +603 5543 1111 ext 6017
www.kpjselangor.com
KPJ Selangor Specialist Hospital