Functional Endoscopic Sinonasal Surgery in Obstructive Sleep Apnea

Abstract

Abstract Background: Functional Endoscopic Sinonasal Surgery needs indicators to determine success outcomes in the management of nasal obstruction-related obstructive sleep apnea (OSA). Materials and Methods: Preexperimental pretest and posttest designed studies were performed to evaluate the percentage changes value of Visual Analog Scale (VAS) nasal obstruction, Nasal Obstruction Symptom Evaluation (NOSE), Epworth Sleepiness Scale (ESS), polysomnographic parameters, and upper airway collapsibility examined by drug-induced sleep endoscopy. Results: Seventeen patients from 2 studies were recruited with mean Apnea-Hypopnea Index of 3.74 ± 3.30 and respiratory disturbance index of 7.03 ± 3.56. The first study showed a significant percentage change in inferior turbinate size, nasal obstruction VAS, peak nasal inspiratory flow, and ESS Score as well as the second study of significant differences pre- and postoperatively of NOSE (from 49.50 ± 19.2 to 4.50 ± 4.4) and ESS (from 12.60 ± 3.6 to 6.60 ± 3.9). Both studies significantly changed the percentage of the duration of Rapid Eye Movement (REM) to 81.4% ±100% (95% confidence interval − 23.6, 186.3) and a significant difference from preoperative of 4.93 ± 4.40% to post-operative of 11.89 ± 6.19%. Three subjects with preoperative epiglottic collapse (EC) showed a mean value of NOSE 60 ± 5 compared to the non-EC collapse of 45 ± 21.6. In postoperative, there were 4 subjects with EC collapse with a NOSE of 6.25 ± 4.7 and 6 subjects without EC collapse with a NOSE of 3.33 ± 4.1. Conclusion: Functional Endoscopic sinonasal surgery improves NOSE, ESS score, and REM sleep in OSA.