Nasal Mass Presenting as Obstructive Sleep Apnea Syndrome

Abstract

Background and ObjectiveaaThe aim of this study was to analyze the clinical symptoms, physical examinations, imaging studies, polysomnographic evaluations, and pathologic findings of patients with a nasal mass presenting as obstructive sleep apnea syndrome (OSAS).MethodsaaThe study population consisted of adult OSAS patients who had a nasal mass and were successfully treated by nasal surgery alone. In this study, we analyzed clinical symptoms, physical examinations, imaging studies, pre and postoperative polysomnographic parameters, and pathologic results of these patients. ResultsaaA series of four patients with OSAS due to a nasal mass were analyzed. The analysis revealed the following: 1) A nasal mass involving the nasopharyngeal space may cause mild to severe OSAS. 2) Isolated nasal surgery may be efficient for the improvement of respiratory disturbances in an OSAS patient with a large nasal mass. 3) We speculated that favorable indications for isolated nasal surgery for the treatment of OSAS are as follows: (1) a huge nasal mass occupying the nasopharynx, (2) small tonsils, (3) low-leveled tongue, (4) relatively young age, and (5) the absence of morbid obesity. ConclusionsaaNasal masses should be considered surgically correctable anatomical abnormalities and potential causes of obstruction when assessing patients with suspected OSAS.

Surgical Outcomes for Obstructive Sleep Apnea in Korea

“…Nasal surgery included inferior turbinate reduction, septal surgery, valve surgical correction, and endoscopic sinus surgery. Many studies have reported investigation of the effect of isolated nasal surgery on OSA [12][13][14][15]. According to a study published in Korea, nasal surgery alone can be a useful option for improving such symptoms as excessive daytime sleepiness, sleep inefficiency, and snoring in OSA patients with nasal obstruction [12].…”

“…Although isolated nasal surgery has a relatively low success rate for OSA, it can be very effective for OSA patients who have surgically correctable anatomical abnormalities. Lee et al [13] indicated that nasal surgery alone may be efficient for the alleviation of minimum oxygen saturation and respiratory events, including apnea and hypopnea, in OSA patients with large nasal masses. Park et al [14] also suggested that isolated nasal surgery may improve not only polysomnography-related parameters but also PAP-related parameters, such as optimal level of PAP and PAP adherence.…”