Critical Appraisal and Meta-Analysis of Nasal Surgery for Obstructive Sleep Apnea

@article{Li2011CriticalAA,
  title={Critical Appraisal and Meta-Analysis of Nasal Surgery for Obstructive Sleep Apnea},
  author={Hsueh-Yu Li and Pa-Chun Wang and Yu-Pin Chen and Li-Ang Lee and Tuan-Jen Fang and Hsin-Ching Lin},
  journal={American Journal of Rhinology \& Allergy},
  year={2011},
  volume={25},
  pages={45 - 49}
}
Background Nasal surgery is commonly involved in surgical treatment for obstructive sleep apnea (OSA). The aim of this study was to investigate the outcomes of nasal surgery for OSA using evidence-based methodology. Methods The MedLine database (1999∼2009) was searched for original articles published in peer-reviewed journals concerning nasal surgery for snoring/sleep apnea. Data extracted from these articles were reviewed and analyzed using meta-analysis technology. Results Thirteen articles… Expand
Does Nasal Surgery Improve OSA in Patients with Nasal Obstruction and OSA? A Meta-analysis
TLDR
The pooled results showed that isolated nasal surgery for patients with nasal obstruction and obstructive sleep apnea improved some sleep parameters, as shown by significant improvements in ESS and RDI, but had no significant improvements on AHI. Expand
Apnea–hypopnea index decreased significantly after nasal surgery for obstructive sleep apnea
TLDR
Both AHI and ESS improved significantly after isolated nasal surgery, but the improvement of AHI is slightly significant, which is needed to confirm the long-term benefits of nasal surgery on OSA. Expand
Effect of nasal and sinus surgery in patients with and without obstructive sleep apnea
TLDR
The pooled results showed isolated nasal and sinus surgery for patients with OSA could improve subjective sleep parameters and reduce daytime sleepiness, but had no significant improvements on objective parameters. Expand
Reviewing the Systematic Reviews in OSA Surgery
TLDR
Although obstructive sleep apnea surgery is associated with improved outcomes in most studies, the level and quality of evidence reviews requires improvement. Expand
THE EFFECT OF NASAL SURGERY ON APNEA-HYPOPNEA INDEX
TLDR
Although nasal obstruction is one of the factors involved in obstructive apnea, one has to keep in mind that surgery will not result in major reduction of obstructive sleep apnea severity to relieve nasal obstruction, so detailed upper airway analysis has to be considered when surgery is an option for obstructiveSleep apnea. Expand
Endoscopic Sinus Surgery Improves Sleep Quality in Chronic Rhinosinusitis: A Systematic Review and Meta-analysis
TLDR
Insight is provided into the effect of CRS-related endoscopic sinus surgery on sleep quality, which should guide future research direction and counseling of patients in the clinical setting. Expand
The Impact of Nasal Surgery on Sleep Quality
TLDR
The degree of change in sleep quality correlates with the severity of nasal obstruction preoperatively and the degree of improvement in obstruction with surgery, and in patients undergoing nasal airway surgery there may be a secondary improvement in subjective sleep quality. Expand
Comprehensive review of surgeries for obstructive sleep apnea syndrome.
TLDR
There is a large amount of variability in outcomes for sleep surgeries, however, in order to maximize success and cure rates, multiple procedures are most often necessary. Expand
Effects of Endoscopic Sinus Surgery and Nasal Surgery in Patients with Obstructive Sleep Apnea
TLDR
Although combined nasal and sinus surgery may slightly improve AHI in a certain group of patients, it does not cure OSA or have a significant clinical impact. Expand
Thirty-five alternatives to positive airway pressure therapy for obstructive sleep apnea: an overview of meta-analyses
TLDR
An overview of the meta-analyses evaluating non-PAP treatments for OSA in adults is provided, finding isolated nasal treatments are the least effective, whereas treatments that bypass the upper airway, significantly open the upperAirway, and/or address multiple levels of theupper airway are more effective in improving apnea–hypopnea index and lowest oxygen saturation. Expand
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References

SHOWING 1-10 OF 21 REFERENCES
Effects of Nasal Surgery on Sleep Quality in Obstructive Sleep Apnea Syndrome with Nasal Obstruction
TLDR
It is suggested that nasal surgery is useful for lowering nasal resistance, ameliorating sleep-disordered breathing, and improving sleep quality and daytime sleepiness in OSAS. Expand
Can Nasal Surgery Improve Obstructive Sleep Apnea: Subjective or Objective?
TLDR
Although nasal surgery relieved snoring and daytime sleepiness, it had variable effects on polysomnographic parameters. Expand
Improvement in quality of life after nasal surgery alone for patients with obstructive sleep apnea and nasal obstruction.
OBJECTIVE To evaluate the impact of nasal surgery alone on quality of life (QOL) in patients with obstructive sleep apnea and nasal obstruction using generic and disease-specific QOL questionnaires.Expand
Randomised trial of nasal surgery for fixed nasal obstruction in obstructive sleep apnoea
TLDR
In conclusion, nasal surgery rarely treats obstructive sleep apnoea effectively and baseline nasal breathing epochs can predict the surgery outcome. Expand
Impact of Endoscopic Sinus Surgery on Sleep Quality in Patients With Chronic Nasal Obstruction Due to Nasal Polyposis
TLDR
Endoscopic sinus surgery with polypectomy significantly improves sleep quality, including snoring and daytime sleepiness in patients with chronic nasal obstruction due to nasal polyposis, however, it has a limited benefit on apnea-hypopnea index scores. Expand
Nasal resistance for determinant factor of nasal surgery in CPAP failure patients with obstructive sleep apnea syndrome.
TLDR
Increased nasal resistance is a determinant of CPAP failure, and the surgical correction of severe nasal obstruction should thus be considered to facilitate treatment of OSAS patients with CPAP. Expand
Polysomnographic effects of nasal surgery for snoring and obstructive sleep apnea
TLDR
Snoring and OSA may be corrected merely by septal surgery in some patients, and secondary surgery (uvulopalatoplasty) may be considered after a thorough evaluation by means of postoperative PSG. Expand
Snoring is not relieved by nasal surgery despite improvement in nasal resistance.
TLDR
Snoring intensity was found to be significantly higher during non-rapid eye movement (NREM) sleep than during rapid eye movement sleep, which may add to the sleep disturbance of a bed partner in the evening. Expand
Effect of improved nasal breathing on obstructive sleep apnea
TLDR
Most patients report improvement in nasal and sleep symptoms after correction of nasal airway obstruction, however, nasal surgery alone does not consistently improve OSA when measured objectively. Expand
Smoking and Improvement after Nasal Surgery in Snoring Men
TLDR
Smokers were younger, they snored longer and louder, and they had higher nasal resistance with decongestion and longer soft palates than the nonsmokers, but a decrease of nasal resistance was not related to improvement of subjective snoring. Expand
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