Effect of nasal surgery on sleep-related breathing disorders.
OBJECTIVE
Single cases of patients who have experienced obstructive sleep apnea (OSA) and who recovered completely after nasal surgery have been described in various studies. The purpose of this study was to evaluate the efficacy of only nasal surgery 1) in a group of patients with obstructive sleep apnea and 2) in simple snorers.


METHODS
A prospective, controlled study with 26 adult patients who underwent nasal surgery as single treatment of their sleep-related breathing disorders. The cases were evaluated based on the severity level of their preoperative Apnea Hypopnea Index (AHI).


METHODS
Between August 1996 and July 2000, 26 patients who snored and had impaired nasal breathing underwent attended polysomnography in the sleep laboratory as single treatment nasal surgery was performed. Postoperative polysomnographic findings and complications were reviewed.


RESULTS
Nineteen of 26 patients (73.1%) were diagnosed as having OSA. Seven patients were simple snorers with an AHI below 10. The surgical response rates, defined as greater than or equal to 50% reduction in the postoperative AHI and a postoperative AHI of less than 20, was 15.8% in the apneics. For the whole group, the AHI decreased postoperatively from 31.6 to 28.9. However, daytime sleepiness improved significantly and arousals decreased significantly in both apneics and simple snorers after nasal surgery.


CONCLUSIONS
We conclude that nasal surgery has a limited efficacy in the treatment of adult patients with sleep apnea. Nevertheless, nasal surgery significantly improves sleep quality and daytime sleepiness independent of the severity of obstructive sleep-related breathing disorders.
Verse
Thomas
T
Department of Otorhinolaryngology, Head and Neck Surgery, Section for Rhinology and Rhonchopathies, University of Ulm, Ulm, Germany. thomas.verse@hno.ma.uni-heidelberg.de
Maurer
Joachim T
JT
Pirsig
Wolfgang
W
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000175:diagnosis / Q000601:surgery*; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome