The Effect Of Nasal Cavity Ventilation Expansion Surgery On Sleep In Patients With Chronic Rhino-sinusitis And Obstructive Sleep Apnea Hypopnea Syndrome

Objective: To evaluate the effects of nasal cavity ventilation expansion surgical technique on nasal resistance and sleep quality in adult patients with chronic rhino-sinusitis and obstructive sleep apnea hypopnea syndrome(OSAHS).Methods: From December 2014 to November 2015, in Beijing An Zhen Hospital affiliated to Capital Medical University, We studied 25 patients suffering from OSAHS diagnosed by polysomnography according to standard protocols and chronic rhino-sinusitis defined by standard criteria. All patients underwent the examination such as polysomnography, otorhinolaryngology specialized physical examination, nasal resistance, sino-nasal outcome test-20 and Epworth sleepiness scale one week before and three months after nasal cavity ventilation expansion surgery only. The primary outcome was improvement in measures of nasal resistance and daytime sleepiness(by the sino-nasal outcome test-20 [SNOT-20] and Epworth sleepiness scale [ESS]). Secondary outcomes included apnea hypopnea index(AHI) and the total recorded time spent below 90% oxygen saturation(TS90). We controlled for other factors that may affect improvement including body mass index(BMI), weight loss, exercise, and medication use. Patients were followed for at least 3 months after surgery.Results: Twenty-five patients were included in our study. Compared with pre-operative examination results in all, the post-operative SNOT-20 scores is from 27.16±5.99 to 11.16±5.11(P<0.001), the post-operative score of the five items on SNOT-20 is from 10.16±2.58 to 2.76±2.19(P<0.001), the ESS score is from 12.56±4.60 to 5.76±2.68(P<0.001), the total nasal resistance is from 0. 245± 0. 0 9(k Pa·s/L)to 0.155±0.06(k Pa·s/L)(P<0.001). The AHI and TS90 did not have significant changes in the patients(P>0.05) after nasal cavity ventilation expansion surgery, but there was a trend to decline.Conclusions: Combining SNOT-20 and ESS with polysomnography can comprehensively assess the effect of patients with chronic rhino-sinusitis and OSAHS after the treatment of nasal cavity ventilation expansion surgery. Selecting the appropriate surgical indications, nasal cavity ventilation expansion surgery can make a great improvement in chronic rhino-sinusitis uncomfortable symptoms and have an effect on sleep quality in adult patients with chronic rhino-sinusitis and OSAHS.