Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada.
Int Forum Allergy Rhinol. 2015 Apr;5(4):329-32. doi: 10.1002/alr.21488. Epub 2015 Jan 26.
Functional endoscopic sinus surgery (FESS) is standard for patients who fail medical management of chronic sinusitis (CRS). The beneficial impact of surgery on CRS is well known. However, patients often note that their sleep is improved after FESS even without simultaneous correction of nasal obstruction. Sleep outcomes after FESS are significantly understudied. Hence in the current study we look to characterize patient sleep quality following sinus surgery.
Data was gathered from 2 sites (Western University [Canada] and the Asia Sleep Center [Singapore]). Patients meeting diagnostic criteria for CRS without nasal polyposis (CRSsNP) were included. Cases with polyposis and those who needed a septoplasty were excluded so as to purely analyze the impact of the sinus surgery on sleep. Sleep outcomes recorded at baseline just prior to surgery and 6 months after surgery were the Epworth Sleepiness Scale (EpSS) and the Pittsburgh Sleep Quality Index (PSQI). We also recorded 22-item Sino-Nasal Outcome Test (SNOT-22) scores and Nasal Obstruction Symptom Evaluation (NOSE) scores. Comparisons were made with paired t tests.
Fifty-three patients met inclusion/exclusion criteria. Sleep outcomes showed a clinically and statistically significant improvement (EpSS before FESS = 14.7 ± 3.1, EpSS after FESS = 9.1 ± 1.1, p < 0.01; PSQI before FESS = 10.9 ± 2.8, PSQI after FESS = 5.3 ± 2.2, p < 0.01). CRS-specific outcomes were improved as well. Nasal obstruction scores did not change significantly.
FESS improved sleep outcomes for the patients in our study. This was independent of correction of nasal obstruction. Sinus surgery for CRSsNP has a beneficial impact on sleep; this novel information can be used during patient counseling and for justification to third-party payers.
对于慢性鼻窦炎（CRS）经药物治疗失败的患者，功能性内镜鼻窦手术（FESS）是标准治疗方法。手术对 CRS 的有益影响是众所周知的。然而，患者经常注意到，即使没有同时纠正鼻塞，他们的睡眠也会在 FESS 后得到改善。FESS 后的睡眠结果研究得还不够充分。因此，在目前的研究中，我们旨在描述鼻窦手术后患者的睡眠质量。
数据来自两个地点（加拿大西安大略大学和新加坡亚洲睡眠中心）。纳入符合无鼻息肉的慢性鼻窦炎（CRSsNP）诊断标准的患者。排除有息肉和需要鼻中隔成形术的病例，以便纯粹分析鼻窦手术对睡眠的影响。在手术前和手术后 6 个月记录的睡眠结果包括嗜睡量表（EpSS）和匹兹堡睡眠质量指数（PSQI）。我们还记录了 22 项鼻-鼻窦炎结局测试（SNOT-22）和鼻部阻塞症状评估（NOSE）评分。采用配对 t 检验进行比较。
53 名患者符合纳入/排除标准。睡眠结果显示出临床和统计学上的显著改善（FESS 前 EpSS = 14.7 ± 3.1，FESS 后 EpSS = 9.1 ± 1.1，p < 0.01；FESS 前 PSQI = 10.9 ± 2.8，FESS 后 PSQI = 5.3 ± 2.2，p < 0.01）。CRS 特异性结局也得到改善。鼻塞评分没有显著变化。
FESS 改善了我们研究中患者的睡眠结果。这与纠正鼻塞无关。FESS 治疗 CRSsNP 对睡眠有有益的影响；这些新信息可用于患者咨询和向第三方付款人说明。
