title: Clinical effect of surgical correction for nasal pathology on the treatment of obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  This study aimed to evaluate the hypothesis that relief of nasal obstruction in subjects with obstructive sleep apnea (OSA) would lead to reduce OSA severity and to discuss the available evidence on the clinical efficacy of nasal surgery as a treatment modality for OSA.
  
  
  METHODS
  Twenty-five subjects who had reduced patency of nasal cavity and narrowing of retroglossal or retropalatal airways were diagnosed with OSA and underwent nasal surgery, such as septoplasty or turbinoplasty to correct nasal pathologies. The effect of the surgery on nasal patency was quantified by measuring minimal cross-sectional area (MCA) using acoustic rhinometry. The watch-PAT-derived respiratory disturbance index (RDI), apnea and hypopnea index (AHI), lowest oxygen saturation, and valid sleep time were measured before and after nasal surgery.
  
  
  RESULTS
  The present study shows that the AHI and RDI decreased significantly and the lowest oxygen saturation and valid sleep time rose after nasal surgery in 25 OSA subjects. In addition, a reduction in subjective symptoms was observed in subjects and mean MCA increased after nasal surgery. Fourteen subjects were classified as responders and 11 subjects as non-responders. Responders showed considerable improvement of their subjective symptoms and the AHI and RDI were significantly lower after surgery. We found that the changes between pre- and post-operative AHI and RDI values were minimal in 11 non-responders. However, daytime somnolence and REM sleep time improved after nasal surgery in non-responders.
  
  
  CONCLUSIONS
  Our study provides evidence that the surgical treatment of nasal pathology improves nasal airway patency and reduces OSA severity in 56% subjects. Furthermore, correction of nasal pathology appears to result in improved sleep quality in both responder and non-responders OSA subjects.
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Chong Yoon
authors.initials: CY
authors.lastname: Park
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Joon Hyeong
authors.initials: JH
authors.lastname: Hong
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Jae Heon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Kyu Eun
authors.initials: KE
authors.lastname: Lee
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Hyun Sang
authors.initials: HS
authors.lastname: Cho
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Lim
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Kwak
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Hyun Jik
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D017286:Polysomnography; D011175:Positive-Pressure Respiration / Q000379:methods; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery* / Q000628:therapy; D012894:Sleep Stages; D016896:Treatment Outcome