Department of Otolaryngology/Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Otolaryngol Head Neck Surg. 2014 Feb;150(2):325-31. doi: 10.1177/0194599813515838. Epub 2013 Dec 13.
To determine if a correlation exists between nasal anatomical obstruction and obstructive sleep apnea severity as measured by overnight polysomnogram (PSG).
Cross-sectional study.
Tertiary medical center.
Subjects were recruited immediately prior to an overnight, in-lab PSG. All subjects who agreed to participate underwent a standardized nasal examination performed by the senior author and then completed the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire, the Snore Outcomes Survey (SOS), and the Epworth Sleepiness Scale (ESS) prior to their sleep study. In addition, tonsil size, Mallampati score, Friedman tongue position, neck circumference, uvula length, and occlusion were assessed and documented. Nasal anatomy assessments were then compared with PSG, NOSE, SOS, and ESS results. Bonferroni correction was used to account for multiple comparisons.
One hundred subjects were included in the study. Fifty-nine subjects (59%) were found to have obstructive sleep apnea syndrome (OSAS) (mean apnea-hypopnea index, 13.1; range, 0-64). Severity of OSAS was associated with age (Spearman's ρ = 0.386, P = .0001). No single nasal anatomy measurement or combined nasal anatomy index was found to correlate with objective sleep-disordered breathing severity measured by PSG. The sample size should have provided 90% power to detect a significant correlation if one existed. After accounting for multiple comparisons, turbinate hypertrophy was found to correlate with the NOSE score (0.3577, P = .0305 corrected), and external and internal nasal valve collapse correlated with each other (0.4986, P < .0001 corrected).
Objectively assessed abnormal nasal anatomy was not found to be significantly correlated with PSG-measured OSAS severity. Specific objective measurements of obstructive nasal anatomy were correlated to subjective measures of nasal obstruction.
确定通过整夜多导睡眠图（PSG）测量的鼻解剖结构阻塞与阻塞性睡眠呼吸暂停严重程度之间是否存在相关性。
横断面研究。
三级医疗中心。
在整夜实验室 PSG 之前，招募受试者。所有同意参与的受试者均由资深作者进行标准化的鼻腔检查，然后在进行睡眠研究之前完成鼻部阻塞症状评估（NOSE）问卷、打鼾结局调查（SOS）和 Epworth 嗜睡量表（ESS）。此外，还评估并记录了扁桃体大小、Mallampati 评分、Friedman 舌位、颈围、悬雍垂长度和咬合情况。然后将鼻腔解剖评估与 PSG、NOSE、SOS 和 ESS 结果进行比较。使用 Bonferroni 校正法来解释多重比较。
本研究共纳入 100 名受试者。59 名受试者（59%）被诊断为阻塞性睡眠呼吸暂停综合征（OSAS）（平均呼吸暂停低通气指数，13.1；范围，0-64）。OSAS 的严重程度与年龄相关（Spearman's ρ = 0.386，P =.0001）。未发现任何单一的鼻腔解剖测量或联合鼻腔解剖指数与 PSG 测量的客观睡眠呼吸障碍严重程度相关。如果存在相关性，样本量应该有 90%的能力检测到显著相关性。在考虑了多次比较后，发现鼻甲肥大与 NOSE 评分相关（0.3577，P =.0305 校正），外部和内部鼻阀塌陷彼此相关（0.4986，P <.0001 校正）。
客观评估的异常鼻腔解剖结构与 PSG 测量的 OSAS 严重程度无明显相关性。阻塞性鼻腔解剖的特定客观测量与主观的鼻腔阻塞测量相关。
