title: Effects of nasal surgery on the upper airway: a drug-induced sleep endoscopy study.
abstract: OBJECTIVE
  To evaluate the impact of nasal surgery on the oropharyngeal and hypopharyngeal anatomy of patients with obstructive sleep apnea (OSA) by comparing drug-induced sleep endoscopy (DISE) data prior to and following nasal surgery.
  
  
  METHODS
  Retrospective review of medical records and DISE video recordings.
  
  
  METHODS
  Twenty-four patients with OSA were identified who underwent nasal surgery for symptomatic nasal obstruction. Clinic charts and DISE video recordings were reviewed. Preoperative and postoperative DISE recordings were compared to determine whether nasal surgery affected the level, degree, and sustainability of upper airway obstruction.
  
  
  RESULTS
  Overall, the pattern of upper airway obstruction did not change significantly following nasal surgery (P > .05). Almost all patients demonstrated residual obstruction by postoperative DISE (96%), with no change in plans for surgical management of oropharyngeal and hypopharyngeal collapse (83%). Partial improvement in palatal collapse was present in a subset of patients without tongue base obstruction (P < .05). Postoperative apnea-hypopnea index decreased from a mean of 23.6 to 20.4 events/hr, but this change was not significant (P > .05).
  
  
  CONCLUSIONS
  For most patients with OSA, surgical repair of nasal obstruction does not significantly improve oropharyngeal or hypopharyngeal collapse as seen on DISE. However, mild improvement in palatal collapse is seen in a subset of patients without tongue base obstruction. This study reveals that if DISE is being utilized to direct surgical management of OSA, it does not need to be repeated for most patients after nasal surgery.
authors.affiliation: Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: Andrew Jacob
authors.initials: AJ
authors.lastname: Victores
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Takashima
mesh_terms: D000328:Adult; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000601:surgery*; D015742:Propofol / Q000008:administration & dosage; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D016896:Treatment Outcome; D014741:Video Recording
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol