Allergic rhinitis tied to nasal surgery success in sleep apnea patients, Finds study

Nasal obstruction is common in patients with obstructive sleep apnea (OSA). Nonetheless, the effectiveness of isolated nasal surgery in treatment of OSA remains controversial.

However, among patients with OSA, those with allergic rhinitis and severe nasal obstruction are likely to have a better surgical outcome following isolated nasal surgery, reveals a recent study published in the American Journal of Otolaryngology.

Sung-Dong Kim and colleagues from the Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, South Korea recently conducted this study to evaluate the subjective and objective outcome after isolated nasal surgery in patients with OSA and to determine the associated factors related to the success rate of isolated nasal surgery.

The study population comprised of a total of 35 patients with nasal obstruction who had been diagnosed with OSA, all of whom were undergoing septoplasty and inferior turbinate reduction to correct nasal pathologies.

Preoperative drug-induced sleep endoscopy was carried out to evaluate the obstruction site. Patients were assessed before and after nasal surgery using subjective outcomes measures, including the Visual Analog Scale and Epworth Sleepiness Scale, as well as by overnight polysomnography.

The following findings were highlighted-

1. All patients experienced improved nasal breathing postoperatively.
2. At 6 months postoperatively, patients exhibited significant symptomatic improvement in snoring, sleep apnea, morning headache, tiredness, and daytime sleepiness.
3. Postoperative polysomnography revealed significant improvement in the apnea-hypopnea index, respiratory disturbance index, and percentage of time with oxygen saturation < 90%.
4. Although the overall success rate of nasal surgery alone was 14.3%, the criteria for success were met in 50% of patients with allergic rhinitis.
5. Furthermore, the success rate was significantly higher in patients with moderate to severe nasal obstruction than in patients with mild nasal obstruction.

Hence, the authors concluded that "among patients with OSA, those with allergic rhinitis and severe nasal obstruction are likely to have a better surgical outcome following isolated nasal surgery."