Nasal Surgery May Improve Upper Airway Collapse in Patients With Obstructive Sleep Apnea: A Drug-Induced Sleep Endoscopy Study
Abstract
OBJECTIVE: The aim of this study is to evaluate the effects of nasal surgery in the upper airway (UA) collapse using drug induced sleep endoscopy (DISE) in a group of patients with obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS: Prospective cohort of patients treated with nasal surgery between 2015 and 2016. All patients were diagnosed with mild to severe OSAHS. The inclusion criteria were age between 18 and 70 years, apnea-hypopnea index (AHI) higher than 15, and septal deviation. All patients had a DISE performed before surgery and 3 months after. The DISE findings were evaluated through the NOHL scale. RESULTS: Thirty-four patients were included. Surgical success with subjective and objective improvement in nasal obstructions was achieved in all cases. The pattern of UA obstruction did change significantly following nasal surgery (P < 0.05). Before nasal surgery, 74% of the patients demonstrated multilevel obstruction. After nasal surgery, only 50% patients showed multilevel collapse (P < 0.05). Among patients with single-level collapse, the oropharynx was the most common location of obstruction. It became more frequent after nasal surgery was done (41% vs 21%, P < 0.05). Significant improvement was shown in hypopharyngeal collapse. Postoperative AHI decreased from a mean of 26.7 to 19 events/h, but this change was not significant. CONCLUSION: Nasal surgery may improve hypopharyngeal collapses observed during DISE in patients with OSAHS. Thus, an improvement in nasal obstruction may also modify the surgical plan based on UA functional findings in OSAHS patients.
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Three studies specifically evaluated the effect of nasal surgery in patients with CPAP intolerance.
“Three studies specifically evaluated the effect of nasal surgery in patients with CPAP intolerance [22,28,30].”
From The Role of Isolated Nasal Surgery in Obstructive Sleep Apnea Therapy—A Systematic Review (2022) · cites this paper as [30]
In the studies of patients with CPAP intolerance, almost all patients tolerated CPAP postoperatively.
“In these studies, almost all patients tolerated CPAP postoperatively.”
From The Role of Isolated Nasal Surgery in Obstructive Sleep Apnea Therapy—A Systematic Review (2022) · cites this paper as [30]
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“Three studies specifically evaluated the effect of nasal surgery in patients with CPAP intolerance [22,28,30].”
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- Authors
- Bosco, G., Pérez-Martín, N., Morato, M., Racionero, M. A., & Plaza, G.
- Affiliations
- Department of Otolaryngology
- Universidad Rey Juan Carlos (ES)
- Corresponding author
- Bosco, Gabriela
- Morato, Marta
- Plaza, Guillermo
- Venue
- Journal of Craniofacial Surgery
- Published
- 2020-01
- Volume
- 31
- Issue
- 1
- Pages
- 68-71
- ISSN
- 1049-2275 (ISSN-L)
- 1536-3732
- OpenAlex
- W2970795870
- Cited by
- 22
- References
- 24
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 15 · 2021: 1
- FWCI
- 2.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Craniofacial 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 › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Keywords
- nasal surgery, obstructive sleep apnea-hypopnea syndrome, upper airway collapse, drug-induced sleep endoscopy, septal deviation, nasal obstruction, oropharyngeal obstruction, apnea-hypopnea index
- MeSH terms
- Adolescent, Adult, Aged, Endoscopy, Female, Humans, Male, Middle Aged, Nose, Oropharynx, Prospective Studies, Sleep, Nasal Obstruction, Polysomnography, Sleep Apnea, Obstructive, Young Adult, Nasal Surgical Procedures
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