Effects of nasal surgery on the upper airway: A drug-induced sleep endoscopy study
Abstract
OBJECTIVES/HYPOTHESIS: To evaluate the impact of nasal surgery on the oropharyngeal and hypopharyngeal anatomy of patients with obstructive sleep apnea (OSA) by comparing drug-induced sleep endoscopy (DISE) data prior to and following nasal surgery. STUDY DESIGN: Retrospective review of medical records and DISE video recordings. METHODS: Twenty-four patients with OSA were identified who underwent nasal surgery for symptomatic nasal obstruction. Clinic charts and DISE video recordings were reviewed. Preoperative and postoperative DISE recordings were compared to determine whether nasal surgery affected the level, degree, and sustainability of upper airway obstruction. RESULTS: Overall, the pattern of upper airway obstruction did not change significantly following nasal surgery (P > .05). Almost all patients demonstrated residual obstruction by postoperative DISE (96%), with no change in plans for surgical management of oropharyngeal and hypopharyngeal collapse (83%). Partial improvement in palatal collapse was present in a subset of patients without tongue base obstruction (P < .05). Postoperative apnea-hypopnea index decreased from a mean of 23.6 to 20.4 events/hr, but this change was not significant (P > .05). CONCLUSIONS: For most patients with OSA, surgical repair of nasal obstruction does not significantly improve oropharyngeal or hypopharyngeal collapse as seen on DISE. However, mild improvement in palatal collapse is seen in a subset of patients without tongue base obstruction. This study reveals that if DISE is being utilized to direct surgical management of OSA, it does not need to be repeated for most patients after nasal surgery.
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Some studies reported on possible confounders; only three studies adjusted statistically for their impact.
“Some studies reported on possible confounders; only three studies adjusted statistically for their impact [12,15,19].”
From The Role of Isolated Nasal Surgery in Obstructive Sleep Apnea Therapy—A Systematic Review (2022) · cites this paper as [15]
One study did not specify the type of nasal surgery.
“One study did not specify the type of nasal surgery [15]”
From The Role of Isolated Nasal Surgery in Obstructive Sleep Apnea Therapy—A Systematic Review (2022) · cites this paper as [15]
The overall AHI was not significantly different after nasal surgery in twelve studies.
“The overall AHI was not significantly different after nasal surgery in twelve studies [15,16,17,18,21,22,23,24,25,28,29,30].”
From The Role of Isolated Nasal Surgery in Obstructive Sleep Apnea Therapy—A Systematic Review (2022) · cites this paper as [15]
In thirteen studies, it was not reported if patients used CPAP during the study period.
“In thirteen studies, it was not reported if patients used CPAP during the study period [12,13,14,15,16,19,20,23,24,26,27,29,32].”
From The Role of Isolated Nasal Surgery in Obstructive Sleep Apnea Therapy—A Systematic Review (2022) · cites this paper as [15]
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Wu, J., Zhao, G., Li, Y., Zang, H., Wang, T., Wang, D., & Han, D. (2017) · Medicine · doi:10.1097/md.0000000000006008 · Cited by 61 · see citing works
The Role of Isolated Nasal Surgery in Obstructive Sleep Apnea Therapy—A Systematic Review
Schoustra, E., van Maanen, P., den Haan, C., Ravesloot, M. J. L., & de Vries, N. (2022) · Brain Sciences · doi:10.3390/brainsci12111446 · Cited by 39 · see citing works
“Some studies reported on possible confounders; only three studies adjusted statistically for their impact [12,15,19].”
BackgroundInfluentialBosco, G., Pérez-Martín, N., Morato, M., Racionero, M. A., & Plaza, G. (2020) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000005865 · Cited by 22 · see citing works
Role of Nasal Surgery in Adult Obstructive Sleep Apnea: A Systematic Review
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“Victores and Takashima 94 compared the DISE fi ndings before and after nasal surgery on 24 patients, reporting that the procedure did not modify the collapse pattern in OSA.”
MethodEvaluation of the clinical efficacy of nasal surgery in the treatment of obstructive sleep apnoea
Wu, J., He, S., Li, Y., Wang, T., Zhao, G., Pan, Y., Zang, H., & Han, D. (2022) · American Journal of Otolaryngology · doi:10.1016/j.amjoto.2021.103158 · Cited by 12 · see citing works
- Authors
- Victores, A. J., & Takashima, M.
- Affiliations
- Baylor College of Medicine (US)
- Corresponding author
- Takashima, Masayoshi
- Venue
- The Laryngoscope
- Publisher
- Wiley
- Published
- 2012-08-08
- Volume
- 122
- Issue
- 11
- Pages
- 2606-2610
- ISSN
- 0023-852X (ISSN-L)
- 1531-4995
- OpenAlex
- W2121899913
- Cited by
- 32
- References
- 60
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 7 · 2016: 1 · 2015: 1 · 2014: 2 · 2013: 2
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Laryngoscope (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Keywords
- nasal surgery, obstructive sleep apnea, upper airway obstruction, drug-induced sleep endoscopy, oropharyngeal collapse, tongue base obstruction, nasal obstruction, apnea-hypopnea index
- MeSH terms
- Adult, Endoscopy, Female, Humans, Male, Middle Aged, Retrospective Studies, Video Recording, Nasal Obstruction, Propofol, Treatment Outcome, Anesthetics, Intravenous, Sleep Apnea, Obstructive
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