Efficacy of Nasal Surgery for Patients with Obstructive Sleep Apnea with Nasal Obstruction

Background: Obstructive sleep apnea (OSA) involves recurring instances of blockage occurring at various levels of the upper airway while asleep. The presence of nasal obstruction is recognized as a contributing factor to the development of OSA. However, efficacy of isolated nasal surgery for OSA in presence of significant nasal obstruction is still unclear. Aim: This study aims to evaluate if nasal surgery alone provides significant improvement in OSA severity and symptoms in patients with nasal obstruction. Patients and methods: This prospective interventional single arm study included 25 patients with OSA with associated subjective complaint of nasal obstruction attending at Otorhinolaryngology Department, Mansoura University Hospitals from May 2022 to May 2023. The complaint of nasal obstruction was subjectively evaluated by using the NOSE scale, preoperatively and postoperatively. Change in apnea-hypopnea index (AHI) was measured as the primary outcome. Results: Based on the Apnea-Hypopnea Index (AHI), there was no notable statistical variance observed in the preoperative and postoperative AHI of patients who received septoplasty and Inferior turbinate reduction. Conversely, individuals who underwent Functional Endoscopic Sinus Surgery exhibited a significant decrease in AHI from 20.75 ± 6.09 to 12.75 ± 3.24 postoperatively (P = 0.001). As regards the nose scale, it was significantly decreased from 12.72 ± 1.46 preoperatively to 6.96 ± 1.31 postoperatively (P value <0.001). Conclusion: Nasal surgery may be effective in improving nasal obstruction in patients with OSA and benign nasal obstruction. However, it has a limited impact in reducing AHI except for patients subjected to Functional Endoscopic Sinus Surgery.