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Irish Journal of Medical Science (1971 -)

Erschienen in:

27.01.2022 | Original Article

Surgical correction of nasal obstruction in obstructive sleep apnea improves CPAP outcomes and compliance

verfasst von: Samy Elwany, Ahmed Yassin Bahgat, Mahmoud Ibrahim, Remon Bazak

Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 6/2022

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Abstract

Background

Although continuous positive airway pressure (CPAP) therapy curtails most of the negative impacts of obstructive sleep apnea (OSA), its efficacy is limited by its low long-term adherence. Nasal obstruction contributes to OSA pathophysiology and necessitates high CPAP titration pressures which reduce CPAP compliance.

Aim

This study aims at elucidating the outcomes of surgical correction of nasal obstruction in patients intolerant to CPAP therapy.

Methods

Forty-nine patients with severe OSA intolerant to CPAP secondary to surgically correctable nasal obstruction were operated upon. Patients were evaluated preoperatively and at least 3 months after the surgical intervention. Subjective assessment entailed the Nasal Obstruction Symptom Evaluation score (NOSE) and the Epworth Sleepiness Scale (ESS). Objectively the patients were assessed by acoustic rhinometry and standard polysomnography.

Results

Nasal surgical intervention resulted in an a statistically significant decrease in the mean NOSE score, ESS and optimal CPAP titration pressure. In addition, the minimal cross-sectional area (MCA1&2) increased significantly postoperatively. There was a positive correlation between the improvement in NOSE score as well as the MCA1& 2 and the postoperative decrease in CPAP titration pressure. Surgical correction of nasal obstruction improved CPAP outcomes and compliance in all patients.

Conclusions

Nasal surgery in OSA objectively assessed by acoustic rhinometry improved nasal obstruction with a resultant decrease in the CPAP pressure requirements. Given that lower CPAP pressures improve adherence to CPAP therapy, surgical alleviation of nasal obstruction should be considered a crucial intervention in the management armamentarium of OSA.

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Titel: Surgical correction of nasal obstruction in obstructive sleep apnea improves CPAP outcomes and compliance
verfasst von: Samy Elwany
Ahmed Yassin Bahgat
Mahmoud Ibrahim
Remon Bazak
Publikationsdatum: 27.01.2022
Verlag: Springer International Publishing
Erschienen in: Irish Journal of Medical Science (1971 -) / Ausgabe 6/2022
Print ISSN: 0021-1265
Elektronische ISSN: 1863-4362
DOI: https://doi.org/10.1007/s11845-021-02896-6

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Surgical correction of nasal obstruction in obstructive sleep apnea improves CPAP outcomes and compliance