Effect of Nasal Surgery on Sleep‐Related Breathing Disorders

Verse, Thomas; Maurer, Joachim T.; Pirsig, W

doi:10.1097/00005537-200201000-00012

Cited by 154 publications

(142 citation statements)

References 28 publications

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“…2 Surgeries included in the study were septorhinoplasty, septoplasty, septoplasty with bilateral sinus surgery, nasal tip surgery, and bilateral nasal valve surgery. They found no significant improvement in the apnea-hypopnea index (AHI) (31.6 to 28.9, P ¼ .52) or oxygen desaturation index (40.3 to 39.7, P ¼ .89), but there were significant reductions in both the Arousal Index and the Epworth Sleepiness Scale (ESS); mean ESS improved from 11.9 to 7.7 (P ¼ .0004), which represents a clinically and statistically significant improvement.…”

Section: Literature Reviewmentioning

confidence: 99%

Is nasal surgery an effective treatment for obstructive sleep apnea?

Rosow

Stewart

2010

The Laryngoscope

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Section: Literature Reviewmentioning

confidence: 99%

Is nasal surgery an effective treatment for obstructive sleep apnea?

Rosow

Stewart

2010

The Laryngoscope

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“…In total, 10 patients were studied (nine males; mean¡SD (range) 46¡5 yrs ; body mass index 27¡1.5 kg?m -2 (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)). The inclusion criteria were as follows: 1) OSA syndrome [27] not yet receiving treatment; 2) clinically significant nasal obstruction (on the basis of clinical examination by M.F.…”

Section: Patientsmentioning

confidence: 99%

“…Similarly, topical nasal decongestants did not reduce OSA severity in patients with nasal obstruction [19,20], but the use of topical nasal steroids in patients with allergic rhinitis was associated with improved subjective sleep quality in adults [21] and with an improvement in apnoea-hypopnoea index (AHI) from 10.7 to 5.8 in children [22]. Nasal surgeries have also been used to treat OSA, but the results have been inconsistent and often lacked adequate objective outcome measurements [23][24][25]. However, SERIES et al [26] demonstrated that the absence of pharyngeal narrowing (as measured by the posterior airway space) in patients with OSA delineated a group with a better response to nasal surgery.…”

mentioning

confidence: 99%

Effect of treating severe nasal obstruction on the severity of obstructive sleep apnoea

McLean

Urton²,

Driver³

et al. 2005

Eur Respir J

126

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An association between mouth breathing during sleep and increased propensity for upper airway collapse is well documented, but the effect of treatment for nasal obstruction on mouth breathing during sleep and simultaneous obstructive sleep apnoea (OSA) severity has not been described previously.A randomised single blind placebo-and sham-controlled crossover study of treatment (topical decongestant and external dilator strip) for nasal obstruction was carried out in 10 patients (nine males; mean¡SEM 46¡5 yrs) with nasal obstruction and OSA. All patients had normal acoustic pharyngometry. The effect of treatment on nasal resistance, mouth breathing during sleep and OSA severity was quantified.Treatment of nasal obstruction was associated with a dramatic and sustained reduction in nasal resistance and the oral fraction of ventilation during sleep (mean (95% confidence interval) absolute reduction in oral fraction 30% (12-49)). Improvements in sleep architecture were observed during active treatment, and there was a modest reduction in OSA severity (change in apnoea-hypopnoea index 12 (3-22)).In conclusion, treating nasal obstruction reduced mouth breathing during sleep and obstructive sleep apnoea severity, but did not effectively alleviate obstructive sleep apnoea.

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“…Apesar dos resultados limitados da cirurgia nasal na cura da SAHOS, benefícios na qualidade do sono são freqüentemente observados. Verse et al 13 preconizam a realização da cirurgia nasal independentemente da gravidade da SAHOS, pois a permeabilização da cavidade nasal leva à diminuição da fragmentação do sono, com melhora na sua qualidade e na sonolência diurna.…”

Section: Discussionunclassified

“…Assim, o tratamento da SAHOS pode ser realizado de diversas formas dependendo da gravidade da doença e das alterações anatômicas da via aérea superior (VAS) e do esqueleto facial destes pacientes 7 . Tratamentos cirúrgicos diversos têm sido propostos e podem tanto envolver a correção de alterações anatômicas encontradas na faringe [8][9][10][11][12] , na cavidade nasal 13 e na base da língua 8,14,15 , como a correção de alterações do esqueleto crâ-nio facial [14][15][16][17] . Os resultados em literatura são controversos e normalmente a indicação dos procedimentos cirúrgicos está relacionada à gravidade da SAHOS e as alterações encontradas na via aérea superior e no esqueleto facial 8,13,18 .…”

Section: Introductionunclassified

Indicação cirúrgica otorrinolaringológica em um ambulatório para pacientes com síndrome da apnéia e hipopnéia obstrutiva do sono

Martinho

Zonato²,

Bittencourt

et al. 2004

Rev. Bras. Otorrinolaringol.

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Obj etivo:Este trabalho tem como objetivo mostrar que o tratamento cirúrgico otorrinolaringológico é uma opção de tratamento para SAHOS e mostrar quais os procedimentos que podem ser realizados e suas indicações. Forma de Estudo: Clínico retrospectivo. Método: Realizamos um estudo retrospectivo em 223 pacientes atendidos no ambulatório de Otorrinolaringologia da UNIFESP, onde todos apresentavam polissonografia basal e foram submetidos a anamnese e exame físico otorrinolaringológico. A conduta terapêuti-ca foi dividida em cirúrgica (procedimentos faríngeos, nasais e craniofaciais) e não-cirúrgica (CPAP, aparelho intraoral e medidas gerais). Resultados: Quase metade dos pacientes (100 pacientes -44,8%) recebeu indicação de algum procedimento cirúrgico, num total de 168 procedimentos, que foram indicados dependendo da gravidade da SAHOS. Desta forma, a uvulopalatofaringoplastia e a radiofreqüência de palato foram indicadas preferencialmente em pacientes com SAHOS leve e moderada e o avanço maxilomandibular em pacientes com SAHOS severa. A amigdalectomia e as cirurgias da cavidade nasal não variaram quanto à gravidade da SAHOS. Conclusão: O tratamento cirúrgico otorrinolaringológico é uma opção de tratamento para pacientes com SAHOS e pode ter intuito curativo ou coadjuvante a outras terapias, melhorando a adaptação ao CPAP. Os procedimentos cirúrgicos devem ser indicados de forma criteriosa baseando-se na gravidade da doença e nas alterações anatômicas da VAS e do esqueleto facial. Ai m:Otolaryngology surgical procedure is an option for obstructive sleep apnea-hypopnea syndrome (OSAHS) treatment. The objective of this study is to show which procedures can be done well as their indications. Study Design: Clinical retrospective. Method: 223 patients with OSAHS were studied in Otolaryngology Department of UNIFESP. Every patient had a previous polissonography, and they were analyzed and treatment options were proposed. The treatment options were divided in no surgical (CPAP, dental appliance and general measures) and surgical procedures (pharynx surgery, rhinosurgery and maxillofacial surgery). Result: 100 patients (44,8%) had surgery indication, and 168 procedures were proposed. The majority uvulopalatopharyngoplasty and radiofrequency of the soft palate were indicated in mild and moderate OSAHS cases and maxillomandibular surgery were indicated in severe cases. Tonsillectomy and rhinosurgery were indicated independently of OSAHS severity. Conclusion: The otolaryngological surgery is an option in OSAHS treatment, and your indication depends on OSAHS severity. The surgical procedure can be done whit curative intetion or to avoid CPAP use.Palavras-chave: apnéia, cirurgia, síndrome da apnéia e hipopnéia obstrutiva do sono.

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Effect of Nasal Surgery on Sleep‐Related Breathing Disorders

Abstract: We conclude that nasal surgery has a limited efficacy in the treatment of adult patients with sleep apnea. Nevertheless, nasal surgery significantly improves sleep quality and daytime sleepiness independent of the severity of obstructive sleep-related breathing disorders.

Cited by 154 publications

References 28 publications

Is nasal surgery an effective treatment for obstructive sleep apnea?

Is nasal surgery an effective treatment for obstructive sleep apnea?

Effect of treating severe nasal obstruction on the severity of obstructive sleep apnoea

Indicação cirúrgica otorrinolaringológica em um ambulatório para pacientes com síndrome da apnéia e hipopnéia obstrutiva do sono

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