TY - JOUR
TI - Randomised trial of nasal surgery for fixed nasal obstruction in
obstructive sleep apnoea
AU - Koutsourelakis, I.
AU - Georgoulopoulos, G.
AU - Perraki, E.
AU - Vagiakis,
AU - E.
AU - Roussos, C.
AU - Zakynthinos, S. G.
JO - The European respiratory journal
PY - 2008
VL - 31
TODO - 1
SP - 110-117
PB - EUROPEAN RESPIRATORY SOC JOURNALS LTD
SN - null
TODO - 10.1183/09031936.00087607
TODO - apnoea/hypopnoea index; nasal breathing epochs; nasal surgery;
obstructive sleep apnoea
TODO - Although nasal surgery has limited efficacy in obstructive sleep apnoea
(OSA) treatment, some patients experience improvement. The present study
tested the hypothesis that post-surgery improvement is associated with
increased nasal breathing epochs. A total of 49 OSA patients (mean
apnoea/hypopnoea index (AHI) 30.1 +/- 16.3 events-h(-1)) with
symptomatic fixed nasal obstruction due to deviated septum were randomly
assigned to either septoplasty (surgery group; 27 patients) or sham
surgery (placebo group; 22 patients). The breathing route was examined
during overnight polysomnography. All patients in the placebo group were
nonresponders, whereas in the surgery group four (14.8%) patients were
responders and exhibited considerable increase in nasal breathing epochs
(epochs containing more than three consecutive phasic nasal signals),
and 23 patients were nonresponders, presenting a modest increase in
nasal breathing epochs. The change in AHI was inversely related to the
change in nasal breathing epochs, with responders exhibiting among the
greatest increases in nasal breathing epochs. Baseline nasal breathing
epochs were positively related to per cent change in AHI. Responders had
among the lowest baseline nasal breathing epochs; a cut-off value of
62.4% of total sleep epochs best separated (100% sensitivity, 82.6%
specificity) responders/nonresponders. In conclusion, nasal surgery
rarely treats obstructive sleep apnoea effectively. Baseline nasal
breathing epochs can predict the surgery outcome.
ER -