title: Can functional septorhinoplasty independently treat obstructive sleep apnea?
abstract: BACKGROUND
  The purpose of this study was to determine whether functional rhinoplasty alone results in a significant improvement in obstructive sleep apnea parameters in patients with nasal obstruction.
  
  
  METHODS
  Records of consecutive adult patients with nasal obstruction who underwent surgery to repair their nasal inlet and completed preoperative and postoperative polysomnography were reviewed. Patients underwent polysomnography before and after functional septorhinoplasty. Long-term follow-up using Nasal Obstruction Symptom Evaluation scores was conducted. Statistical analysis was performed using the Wilcoxon signed rank sum test. A Holm-Bonferroni sequential correction was also used because of multiple statistical comparisons being made.
  
  
  RESULTS
  Twenty-six patients were included in this study. Mean apnea-hypopnea index scores preoperatively was 24.7, which dropped to a mean postoperative apnea-hypopnea index of 16, a reduction of 35 percent (p = 0.013). Excluding patients with a body mass index greater than 30 resulted in improved apnea-hypopnea index scores, from 22.5 to 9.6, a mean 57 percent reduction (p < 0.01).
  
  
  CONCLUSIONS
  Functional rhinoplasty may have the potential to significantly improve the severity of obstructive sleep apnea for select patients with nasal obstruction. The nasal airflow improvement may modify pharyngeal aerodynamics. This is a fast and minimally invasive approach to consider in patients with obstructive sleep apnea and nasal obstruction, especially in patients with a body mass index less than 30.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Bronx, N.Y.; and New Orleans, La. From the Department of Otolaryngology/Head and Neck Surgery, and the Department of Epidemiology and Population Health, Division of Biostatistics, Albert Einstein College of Medicine; Hedgewood Surgical Center; and the Department of Otolaryngology, Tulane University School of Medicine.
authors.forename: Stefan W
authors.initials: SW
authors.lastname: Shuaib
authors.forename: Satyen
authors.initials: S
authors.lastname: Undavia
authors.forename: Juan
authors.initials: J
authors.lastname: Lin
authors.forename: Calvin M
authors.initials: CM
authors.lastname: Johnson
authors.forename: Howard D
authors.initials: HD
authors.lastname: Stupak
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000175:diagnosis / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery / Q000637:transplantation*; D017286:Polysomnography / Q000379:methods; D011182:Postoperative Care; D011300:Preoperative Care; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D018570:Risk Assessment; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome