Abstract
BackgroundThe objective of this observational study was to evaluate the outcomes of intranasal surgery in patients with obstructive sleep apnea (OSA) in a single institution in Norway.MethodsFifty-nine patients with OSA and clinically significant nasal obstruction underwent either septoplasty alone or septoplasty with concomitant volume reduction of the turbinates from August 2008 until the end of December 2010. Subjects were scheduled for sleep polygraphy before and 3 months after treatment.In this observational single-centre cohort study we evaluated and compared the effect of these two specific surgical procedures on sleep related parameters.ResultsThere was a significant reduction in the apnea-hypopnea index (AHI) only in the group that had septoplasty with turbinate reduction (17.4, (SD 14.4) – 11.7, (SD 8.2), p <0.01), and this effect was significantly better than in the group treated with septoplasty alone. Other objective parameters remained unchanged. Subjective assessments obtained with a postoperative questionnaire showed an equally positive effect on diurnal sleepiness and nasal obstruction in both groups, and a better effect on sleep quality in the combined treatment group.ConclusionThe effect of nasal surgery on obstructive sleep apnea seemed to be greater when there were indications for combined surgery of the inferior turbinates and the nasal septum, compared to when there were indications for septoplasty alone.
Highlights
The objective of this observational study was to evaluate the outcomes of intranasal surgery in patients with obstructive sleep apnea (OSA) in a single institution in Norway
In both groups together, there was no significant reduction in mean apnea-hypopnea index (AHI) after surgery: 18.1 (±13.7) - 16.6 (±12.9), p = 0.365, mean oxygen desaturation index (ODI): 14.2 (±12.3) – 12.4 (±10.7), p = 0.229 or mean body mass index (BMI): 28.1 (±3.2) – 28.3 (±3.0), p = 0.422
In comparison, when we looked at each group separately, we found a significant reduction in group 2 in mean AHI: 17.4 (±14.4) – 11.7 (±8.2), p = 0.007 and mean Epworth Sleepiness Scale (ESS): 9.7 (±3.4) – 7.6 (±2.2), p = 0.006
Summary
The objective of this observational study was to evaluate the outcomes of intranasal surgery in patients with obstructive sleep apnea (OSA) in a single institution in Norway. There is growing interest in the field of sleep-related disorders (SRD) and in obstructive sleep apnea (OSA) . This is due to the impact of SRD on global health, and a result of more profound insight into the effects of sleep deprivation, and the biomechanical and physiological changes that occur during the development of upper airway collapse during sleep [1]. The traditional way of understanding the collapsing airway includes both theories of neuromuscular regulation [2] and theories of knowledge, there are no other clinical studies that compare the results of different nasal procedures for nasal obstruction in patients with OSA. We have evaluated and compared the results of two specific surgical procedures in the nasal cavity, septoplasty alone and septoplasty with simultaneous turbinate volume reduction
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