title: The effect of compound nasal surgery on obstructive sleep apnea syndrome.
abstract: BACKGROUND
  Nasal surgery often fails to ameliorate the symptoms of obstructive sleep apnea syndrome (OSAS). We developed a compound nasal surgery (CNS) method that consists of septoplasty combined with submucosal inferior turbinectomy and posterior nasal neurectomy to ensure low nasal resistance during sleep.
  
  
  OBJECTIVE
  To clarify the effect of CNS on OSAS, pre- and postoperative changes in sleep-related events were studied by using polysomnography, the Epworth sleepiness scale (ESS), the visual analog scale for snoring, and health-related quality of life (QOL).
  
  
  METHODS
  Forty-five consecutive patients with OSAS and with nasal problems underwent CNS. Three months later, the postoperative effect on OSAS was assessed by using polysomnography findings, daytime sleepiness by the ESS, nasal allergy symptoms, and health-related QOL. Snoring was assessed by the family by using a visual analog scale.
  
  
  RESULTS
  The indices of apnea, apnea-hypopnea, oxygen desaturation, and arousal; the ESS; allergic symptom score; health-related QOL; and snoring on a visual analog scale were all significantly improved.
  
  
  CONCLUSIONS
  CNS improves OSAS events without any pharyngeal surgical procedure in selected patients. If high nasal resistance associated with OSAS is present, then CNS should thus be considered.
authors.affiliation: Tsuchiura Snoring and Sleep-Disordered Breathing Center, Nihon University Hospital, Tsuchiura City, Ibaraki Prefecture, Japan.
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Hisamatsu
authors.forename: Itsuhiro
authors.initials: I
authors.lastname: Kudo
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Makiyama
mesh_terms: D000328:Adult; D000368:Aged; D000403:Airway Resistance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D059747:Nasal Surgical Procedures; D017286:Polysomnography; D011788:Quality of Life; D012189:Retrospective Studies; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications / Q000523:psychology / Q000601:surgery*; D012890:Sleep / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D016896:Treatment Outcome; D014420:Turbinates / Q000601:surgery