What is the efficacy of nasal surgery in patients with obstructive sleep apnea syndrome?
OBJECTIVE
Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive episodes of partial or complete obstruction of the upper airway during sleep and is associated with increasing respiratory efforts, with a consequent oxyhemoglobin desaturation, sleep fragmentation, and daytime symptoms, most commonly excessive sleepiness. The effectiveness of continuous positive airway pressure (CPAP) is undoubtedly high in treating those patients who use it regularly, but for those who refuse it, the success rate is 0. It is for this subset of patients that surgical therapy can be useful. The purpose of this study was to evaluate the effects of nasal surgery on nasal resistance, sleep apnea, sleep quality, and nasal volumetric measurement in adult male patients with OSAS.


METHODS
Twenty male patients with complaints of hypersomnia and snoring were included in the study. Polysomnography of patients with the prediagnosis of OSAS was planned. All patients underwent CPAP treatment before and after surgery. Patients, who had anatomic structural defects causing nasal valve shrinkage, were operated on at the Plastic Reconstructive and Aesthetic Department. Volumetric measurements of the nose were obtained before and after the operation.


RESULTS
In our study, it was observed that respiratory tract space of patients increased subsequent to the surgery, and thereby OSAS level decreased, and tolerating CPAP device was easier. Measurements of internal nasal valve vertex and fields and external nasal valve fields before and after operation were significant.


CONCLUSIONS
Surgical relief of this nasal obstruction may improve quality of life in patients with OSAS.
Department of Neurology Medicine, Uludag University Medical Faculty, Bursa, Turkey. aylinbican@mynet.com
Aylin
A
Bican
Ahmet
A
Kahraman
Ibrahim
I
Bora
Ramazan
R
Kahveci
Bahattin
B
Hakyemez
D000328:Adult; D000403:Airway Resistance / Q000502:physiology; D019412:Anatomy, Cross-Sectional; D002508:Cephalometry; D045422:Continuous Positive Airway Pressure; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000601:surgery; D009666:Nose / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D010100:Oxygen / Q000097:blood; D017286:Polysomnography; D012123:Pulmonary Ventilation / Q000502:physiology; D011788:Quality of Life; D012890:Sleep / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000517:prevention & control; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D012894:Sleep Stages / Q000502:physiology; D012913:Snoring / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome
D010100:Oxygen