Apnea–hypopnea index decreased significantly after nasal surgery for obstructive sleep apnea

Abstract

Background:Nasal surgeries have been applied to obstructive sleep apnea (OSA) patients with nasal obstruction for decades. However, the efficiency of nasal surgery in improving OSA remains controversial.The aim of this study was to identify whether isolated nasal surgery can improve apnea–hypopnea index (AHI).Methods:Computerized searches were performed in MEDLINE, Web of Science, Cochrane Library, and Scopus from January 1, 2000 to April 30, 2016. A total of 18 articles and 587 participants were included. There were 1 randomized controlled trials, 2 nonrandomized trials, 11 prospective studies, and 4 retrospective studies. Data regarding study design (prospective/retrospective clinical trial, randomized, and controlled), population size, participant characteristics (age, gender, and body mass index), surgical intervention, and outcomes (AHI, Epworth sleep scale [ESS]) was collected.Results:Statistically significant improvement in AHI (subgroup 1: weighted mean difference [WMD] [95%confidence interval (CI)], −4.17 [−7.62, −0.73]; subgroup 2: WMD [95%CI], −4.19 [−7.51, −0.88]; overall: WMD [95%CI], −4.15 [−6.48, −1.82]) and ESS (subgroup 1: WMD [95%CI], −2.14 [−3.08, −1.19]; subgroup 2: WMD [95%CI], −4.70 [−5.95, −3.44]; overall: WMD [95%CI], −4.08 [−5.27, −2.88]) was revealed.Conclusion:Both AHI and ESS improved significantly after isolated nasal surgery, but the improvement of AHI is slightly significant. Future randomized controlled trials are needed to confirm the long-term benefits of nasal surgery on OSA.

Barbed expansion sphincter pharyngoplasty for the treatment of oropharyngeal collapse in obstructive sleep apnoea syndrome: A retrospective study on 17 patients

“…Eleven patients underwent nasal surgery together with BESP to relieve symptomatic nasal obstruction. A recent meta‐analysis indicates that nasal surgery has a slightly significant impact on AHI, with a weighted mean AHI reduction of 4.15 . Still, even taking into account the possible role of nasal surgery, much of the AHI reduction that we observed (median difference between pre‐ and postoperative AHI: 17.4) can be reasonably attributed to BESP.…”

Simulation of the upper airways in patients with obstructive sleep apnea and nasal obstruction: A novel finite element method

“…In addition to increasing the compliance for pressure devices, the surgical alterations in the nasal cavity are reported to reduce the AHI by 50% in 15% of the patients. 47,48 We found an average reduction in AHI of 19.2% and a surgical success in 33% three months after nasal surgery. All patients had septoplasty and turbinectomy performed.…”

“…Nasal surgery relieves symptoms in most OSA patients and is known to reduce the number of apneas to some degree . However, no guidelines exist as to what type of nasal surgery to perform and no method is available to predict the surgical outcome.…”

“…However, no guidelines exist as to what type of nasal surgery to perform and no method is available to predict the surgical outcome. In addition to increasing the compliance for pressure devices, the surgical alterations in the nasal cavity are reported to reduce the AHI by 50% in 15% of the patients . We found an average reduction in AHI of 19.2% and a surgical success in 33% three months after nasal surgery.…”

“…Nasal surgery relieves symptoms in most OSA patients 45,46 and is known to reduce the number of apneas to some degree. 47 However, no guidelines exist as to what type of nasal surgery to perform and no method is available to predict the surgical outcome. In addition to increasing the compliance for pressure devices, the surgical alterations in the nasal cavity are reported to reduce the AHI by 50% in 15% of the patients.…”