Can functional septorhinoplasty independently treat obstructive sleep apnea?
Abstract
BACKGROUND: The purpose of this study was to determine whether functional rhinoplasty alone results in a significant improvement in obstructive sleep apnea parameters in patients with nasal obstruction. METHODS: Records of consecutive adult patients with nasal obstruction who underwent surgery to repair their nasal inlet and completed preoperative and postoperative polysomnography were reviewed. Patients underwent polysomnography before and after functional septorhinoplasty. Long-term follow-up using Nasal Obstruction Symptom Evaluation scores was conducted. Statistical analysis was performed using the Wilcoxon signed rank sum test. A Holm-Bonferroni sequential correction was also used because of multiple statistical comparisons being made. RESULTS: Twenty-six patients were included in this study. Mean apnea-hypopnea index scores preoperatively was 24.7, which dropped to a mean postoperative apnea-hypopnea index of 16, a reduction of 35 percent (p = 0.013). Excluding patients with a body mass index greater than 30 resulted in improved apnea-hypopnea index scores, from 22.5 to 9.6, a mean 57 percent reduction (p < 0.01). CONCLUSIONS: Functional rhinoplasty may have the potential to significantly improve the severity of obstructive sleep apnea for select patients with nasal obstruction. The nasal airflow improvement may modify pharyngeal aerodynamics. This is a fast and minimally invasive approach to consider in patients with obstructive sleep apnea and nasal obstruction, especially in patients with a body mass index less than 30. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
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 [19]
In the remaining eight studies, the overall AHI decreased significantly after nasal surgery.
“In the remaining eight studies, the overall AHI decreased significantly after nasal surgery [12,13,19,20,26,27,31,32].”
From The Role of Isolated Nasal Surgery in Obstructive Sleep Apnea Therapy—A Systematic Review (2022) · cites this paper as [19]
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 [19]
Cites
Clinical consensus statement: Diagnosis and management of nasal valve compromise
Rhee, J. S., Weaver, E. M., Park, S. S., Baker, S. R., Hilger, P. A., Kriet, J. D., Murakami, C. S., Senior, B. A., Rosenfeld, R. M., & DiVittorio, D. (2010) · Otolaryngology · doi:10.1016/j.otohns.2010.04.019 · Cited by 213 · see citing works
Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance
Virkkula, P., Bachour, A., Hytönen, M. L., Salmi, T. K., Malmberg, H., Hurmerinta, K. A., & Maasilta, P. K. (2006) · CHEST Journal · doi:10.1378/chest.129.1.81 · Cited by 86 · see citing works
Impact of Nasal Obstruction on Obstructive Sleep Apnea
Friedman, M., Maley, A., Kelley, K., Leesman, C., Patel, A., Pulver, T., Joseph, N., & Catli, T. (2011) · Otolaryngology–Head and Neck Surgery · doi:10.1177/0194599811400977 · Cited by 60 · see citing works
Choi, J. H., Kim, E. J., Kim, Y. S., Kim, T. H., Choi, J., Kwon, S. Y., Lee, H. M., Lee, S. H., & Lee, S. H. (2011) · American Journal of Rhinology & Allergy · doi:10.2500/ajra.2011.25.3654 · Cited by 54 · see citing works
The efficacy of nasal surgery in obstructive sleep apnea syndrome: A prospective clinical study
Sufioğlu, M., Ozmen, O. A., Kasapoglu, F., Demir, U. L., Ursavas, A., Erişen, L., & Onart, S. (2012) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-011-1682-z · Cited by 52 · see citing works
Shadfar, S., Shockley, W., Fleischman, G., Dugar, A. R., McKinney, K., Frank-Ito, D., & Kimbell, J. (2014) · JAMA Facial Plastic Surgery · doi:10.1001/jamafacial.2014.395 · Cited by 40 · see citing works
Burger, C. D., Stanson, A. W., Daniels, B. K., Sheedy, P. F., & Shepard, J. (1993) · CHEST Journal · doi:10.1378/chest.103.4.1032 · Cited by 24 · see citing works
Kimbell, J. S., Shadfar, S., Shockley, W., et al. (2020) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/5s8w-gg04 · Cited by 4 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
International Consensus Statement on Obstructive Sleep Apnea
Chang, J. L., Goldberg, A. N., Alt, J. A., Mohammed, A., Ashbrook, L., Auckley, D., Ayappa, I., Bakhtiar, H., Barrera, J. E., Bartley, B. L., et al. (2023) · International Forum of Allergy & Rhinology · doi:10.1002/alr.23079 · Cited by 350 · see citing works
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
Nasal Surgery for Obstructive Sleep Apnea Syndrome
Mickelson, S. A. (2016) · Otolaryngologic Clinics of North America · doi:10.1016/j.otc.2016.07.002 · Cited by 33 · see citing works
The effects of nasal decongestion on obstructive sleep apnoea
An, Y., Li, Y., Kang, D., Sharama-adhikari, S. K., Xu, W., Li, Y., & Han, D. (2019) · American Journal of Otolaryngology · doi:10.1016/j.amjoto.2018.08.003 · Cited by 20 · see citing works
Sharma, S., Wormald, J. C. R., Fishman, J. M., Andrews, P., & Kotecha, B. T. (2019) · The Journal of Laryngology & Otology · doi:10.1017/s0022215119000240 · Cited by 16 · see citing works
Evaluation 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
Evidence-Based Medicine: The role of nasal surgery in treatment of obstructive sleep apnea
Newsome, H. (2023) · Facial Plastic Surgery · doi:10.1055/a-2031-3289 · Cited by 3 · see citing works
- Authors
- Shuaib, S. W., Undavia, S., Lin, J., Johnson, C. M., & Stupak, H. D.
- Affiliations
- Tulane University (US)
- Jacobi Medical Center (US)
- Venue
- Plastic and Reconstructive Surgery
- Published
- 2015-06
- Volume
- 135
- Issue
- 6
- Pages
- 1554-1565
- ISSN
- 0032-1052 (ISSN-L)
- OpenAlex
- W2409090051
- Cited by
- 46
- References
- 8
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 3 · 2020: 7 · 2019: 6 · 2018: 6 · 2017: 7 · 2016: 5
- FWCI
- 4.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Plastic & Reconstructive Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
- Keywords
- obstructive sleep apnea, nasal obstruction, apnea-hypopnea index, nasal airflow, body mass index, polysomnography
- MeSH terms
- Adult, Female, Follow-Up Studies, Humans, Male, Middle Aged, Nasal Septum, Postoperative Care, Preoperative Care, Retrospective Studies, Rhinoplasty, Severity of Illness Index, Time Factors, Cohort Studies, Nasal Obstruction, Body Mass Index, Treatment Outcome, Polysomnography, Risk Assessment, Sleep Apnea, Obstructive
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
