Jiang Rong-San, Liang Kai-Li
Department of Medical Research, Taichung Veterans General Hospital, Taiwan.
Department of Otolaryngology, Taichung Veterans General Hospital, Taiwan.
Int J Otolaryngol. 2019 Jun 2;2019:7951045. doi: 10.1155/2019/7951045. eCollection 2019.
Chronic rhinosinusitis (CRS) patients often complain of nasal obstruction, which may cause sleep impairment for them. The goal of this study was to investigate the influence of functional endoscopic sinus surgery (FESS) on sleep related outcomes in CRS patients.
CRS patients who received FESS were included in this study. Prior to FESS and 3 months after surgery the patients were asked about the severity of nasal obstruction and completed the 20-item Sinonasal Outcome Test (SNOT-20), along with the Epworth Sleepiness Scale (ESS) questionnaire. Endoscopic examination, acoustic rhinometry, and polysomnography were performed in all patients. They were divided into four groups according to their preoperative apnea hypopnea index (AHI) scores: nonobstructive sleep apnea syndrome (non-OSAS), mild OSAS, moderate OSAS, and severe OSAS.
A total of 96 subjects completed the study. The scores of the sleep domain of the SNOT-20 and ESS decreased in all of the AHI groups, with the exception of the severe OSAS group, after FESS. A reduction in the AHI of less than 5 was achieved in 9 patients (13.2%) after FESS.
Our results showed that FESS improved sleep quality in CRS patients, except those with severe OSAS, and a preoperative lower AHI was the only significant predictor of post-FESS OSAS outcome.
慢性鼻-鼻窦炎(CRS)患者常主诉鼻塞,这可能导致他们睡眠障碍。本研究的目的是调查功能性鼻内镜鼻窦手术(FESS)对CRS患者睡眠相关结果的影响。
本研究纳入接受FESS的CRS患者。在FESS术前及术后3个月,询问患者鼻塞的严重程度,并让他们完成20项鼻鼻窦结局测试(SNOT-20)以及爱泼沃斯思睡量表(ESS)问卷。对所有患者进行鼻内镜检查、鼻声反射测定和多导睡眠监测。根据术前呼吸暂停低通气指数(AHI)评分将他们分为四组:非阻塞性睡眠呼吸暂停低通气综合征(非OSAS)、轻度OSAS、中度OSAS和重度OSAS。
共有96名受试者完成了本研究。FESS术后,除重度OSAS组外,所有AHI组的SNOT-20睡眠领域评分和ESS评分均下降。FESS术后9例患者(13.2%)的AHI降低了5次以下。
我们的结果表明,FESS改善了CRS患者的睡眠质量,重度OSAS患者除外,术前较低的AHI是FESS术后OSAS结局的唯一显著预测因素。