Omission of polysomnography in treatment of snoring: common reasons and medico-legal implications

Although polysomnography (PSG) is an important investigation in the treatment of snorers, it was observed that a large number of patients did not have pre-operative PSG assessment in a tertiary hospital in Singapore. Of the 118 Asian patients who underwent surgery for snoring from January 1997 to De...

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Bibliographic Details
Published in:Journal of laryngology and otology 2000-07, Vol.114 (7), p.519-521
Main Authors: Goh, Y. H., Choy, D. K. S.
Format: Article
Language:English
Subjects:
(RF) Otorhinolaryngology
Adult
Biological and medical sciences
Body mass index
Cohort Studies
Diagnosis, Differential
Female
Forensic medicine
Hospitals
Humans
Male
Males
Malpractice
Medical sciences
Middle Aged
Non tumoral diseases
Otorhinolaryngology. Stomatology
Patients
Physiology
Polysomnography
Polysomnography - statistics & numerical data
Public health. Hygiene
Public health. Hygiene-occupational medicine
Retrospective Studies
Sleep apnea
Sleep Apnea Syndromes - diagnosis
Sleep Apnea, Obstructive - diagnosis
Sleep disorders
Snoring
Snoring - diagnosis
Snoring - surgery
Surgery
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
White people
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Summary:Although polysomnography (PSG) is an important investigation in the treatment of snorers, it was observed that a large number of patients did not have pre-operative PSG assessment in a tertiary hospital in Singapore. Of the 118 Asian patients who underwent surgery for snoring from January 1997 to December 1998, 36 (30.5 per cent) of patients did not have pre-operative PSG and only 21 (17.8 per cent) of patients had post-operative PSG. In this cohort, 43 (36.4 per cent) patients presented with snoring as their only complaint and not associated with symptoms indicative of obstructive sleep apnoea syndrome (OSAS). Thirty-one of these ‘simple snorers’ underwent sleep studies with the following outcome: two (6.5 per cent) true simple snorers, two (6.5 per cent) upper airway resistance syndrome, nine (29 per cent) mild OSAS, seven (22.6 per cent) moderate OSAS and 11 (35.5 per cent) severe OSAS. Our study showed that without the aid of PSG, it would be difficult to predict the severity of sleep apnoea based on clinical history alone. In an increasingly litigation-conscious society such as Singapore, there is therefore little justification in omitting PSG in the treatment of snoring. The common reasons for omission of preoperative PSG and the medico-legal implications are also discussed.
ISSN:0022-2151
1748-5460
DOI:10.1258/0022215001906273