Effect of Septoplasty on Objective and Subjective Parameters of Osas Treatment

Year 2021, Volume: 31 Issue: 1, 10 - 15, 06.07.2021

Ela Araz Server Engin Acıoğlu Özgür Yiğit Ecem Sevim Akı Nihal Seden Ahmet Görkem Yasak

https://doi.org/10.26650/Tr-ENT.2021.41275

Abstract

Objective: The aim of this study was to investigate the effect of isolated septoplasty on polysomnography (PSG) data and subjective findings in patients with OSAS.
Materials and Methods: A total of 25 patients with symptoms of nasal obstruction, septum deviation and who had been diagnosed with OSAS, were included in the study. All patients underwent isolated septoplasty. The PSG prior to and 6 months after the operation, were recorded. The Epworth sleepiness scale (ESS), the Pittsburgh Sleep Quality Index (PSQI) and Snore Outcomes Survey were performed prior to and 6 months after the operation.
Results: The postoperative apnea-hypopnea index (AHI) score, minimum oxygen saturation (MOS) and the snoring time were statistically significantly decreased compared to the preoperative measurements (p=0,000, p=0,01 and p=0,000, respectively). The rate of patients with a decrease in the AHI index of more than 50%, was 56%. A significant decrease was observed in the ESS and snore outcome survey measurements compared to the preoperative measurements. In PSQI, all sub-factor scores except postoperative medication were determined to be significantly decreased compared to the preoperative period (p<0.05). No correlation was observed between AHI and ESS, snore outcome survey and the PSQI reduction (p>0.05).
Conclusion: Isolated septoplasty leads to an improvement in the subjective and objective parameters of the patients with OSAS and symptoms of nasal obstruction, although not to a complete recovery.

Keywords

Obstructive sleep apnea syndrome, snoring, polysomnography, apnea-hypopnea index, septoplasty

References

• 1. Gaudette E, Kimoff RJ. Pathophysiology of OSA. Eur Respir Mon 2010;50:31-50. google scholar
• 2. Malow BA. Approach to the patient with disordered sleep In: Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. 4th Ed. Philadelphia, WB Saunders 2005;589-93. google scholar
• 3. Schlosshan D, Elliott MW. Clinical presentation and diagnosis of the obstructive sleep apnea hypopnea syndrome. Thorax 2004;59:347-52. google scholar
• 4. Schwab RJ, Remmers JE, Kuna ST. Chapter 101 - Anatomy And Physiology of Upper Airway Obstruction. In: Kryger MH, Roth T, Dement WC (eds). Principles and Practice of Sleep Medicine, 5th ed. Missouri: Elsevier Saunders 2011:1153-71. google scholar
• 5. Gharibeh T, Mehra R. Obstructive sleep apnea syndrome: natural history, diagnosis, and emerging treatment options. Nat Sci Sleep 2010;2:233-55. google scholar
• 6. Woodson BT. Sleep Medicine and Surgery. In: James Snow, P. Ashley Wackym, ed. Ballenger’s Otolaryngology, Head and Neck Surgery, centennial ed. New York : People’s Medical Publishing House. BC Decker Inc. 2009:983-96. google scholar
• 7. Ishii L, Roxbury C, Godoy A, et al. Does nasal surgery improve OSA in patients with nasal obstruction and OSA? A meta-analysis. Otolaryngol Head Neck Surg 2015;153:326-33. google scholar
• 8. Li HY, Wang PC, Chen YP, et al. Critical appraisal and meta-analysis of nasal surgery for obstructive sleep apnea. Am J Rhinol Allergy 2011;25:45-9. google scholar
• 9. Wu J, Zhao G, Li Y, Zang H, Wang T, Wang D, Han D. Apnea-hypopnea index decreased significantly after nasal surgery for obstructive sleep apnea: A meta-analysis. Medicine (Baltimore). 2017;96(5):e6008 google scholar
• 10. Baumann I, Baumann H. A new classification of septal deviations. Rhinology 2007;45:220-3. google scholar
• 11. Mickelson SA. Nasal Surgery for Obstructive Sleep Apnea Syndrome. Otolaryngol Clin North Am 2016;49(6):1373-81. google scholar
• 12. Meen EK, Chandra RK. The role of the nose in sleep disordered breathing . Am J Rhinol Allergy 2013;27(3):213-20. google scholar
• 13. Park CY, Hong JH, Lee JH, et al. Clinical effect of surgical correction for nasal pathology on the treatment of obstructive sleep apnea syndrome. PloSOne 2014;9:e9876. google scholar
• 14. Moxness MH, Nordgârd S. An observational cohort study of the effects of septoplasty with or without inferior turbinate reduction in patients with obstructive sleep apnea. BMC Ear Nose Throat Disord 2014;14:11. google scholar
• 15. Bury SB, Singh A. The role of nasal treatments in snoring obstructive sleep apnoea . Curr Opin Otolaryngol Head Neck Surg 2015;23:39-46. google scholar
• 16. Wu J, Zang HR, Wang T, Zhou B, Ye JY, Li YC, Han DM. Evaluation of the subjective efficacy of nasal surgery. J Laryngol Otol 2017;131(1):37-43. google scholar
• 17. Ertugay CK, Toros SZ, Karaca CT, Kulekci S, Verim A, Ertugay OC, Naiboglu B. Is septoplasty effective on habitual snoring in patients with nasal obstruction ?Eur Arch Otorhinolaryngol. 2015;272(7):1687-91. google scholar
• 18. Lorente J, Jurado MJ, Romero O, Quesada P, Quesada JL, Sagales T. Effects Of Functional Septoplasty in obstructive sleep apnea syndrome. Med Clin (Barc). 2005;125(8):290-2. google scholar
• 19. Buysse DJ, Hall ML, Strollo PJ, et al. Relationships between the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and clinical/polysomnographic measures in a community sample. J Clin Sleep Med 2008;4:563-71. google scholar
• 20. Stapleton AL, Chang YF, Soose RJ, Gillman GS. The impact of nasal surgery on sleep quality: a prospective outcomes study. Otolaryngol Head Neck Surg 2014;151(5):868-73. google scholar