Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts.
Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts.
Facial Plast Surg Aesthet Med. 2020 Jan/Feb;22(1):25-35. doi: 10.1089/fpsam.2019.29002.lin.
Sleep-disordered breathing (SDB) represents a spectrum of sleep-related disorders associated with significant medical comorbidities. Nasal airway surgery has been shown to improve SDB but no large-scale studies exist that describe the long-term impact of surgery on patient perception of snoring and nasal obstruction. To characterize longitudinal snoring symptoms and nasal obstruction after functional nasal surgery for patients with SDB, stratified by history of snoring or obstructive sleep apnea (OSA). In this prospective cohort study, patients undergoing nasal surgery between 2013 and 2017 at a tertiary academic center were surveyed using Snoring Outcome Survey (SOS) and Nasal Obstruction Symptom Evaluation (NOSE) questionnaires through 24 months postoperatively. Patient demographics, history of snoring, diagnosis of OSA, and prior nasal surgeries were analyzed. A total of 625 patients were recruited with 325 females (52.0%) and mean age of 36.3 years (SD 15.6), with 74.9% patients reported snoring ( = 468) and 10.7% patients ( = 67) with OSA. Patients undergoing dual functional and cosmetic septorhinoplasty with or without turbinate surgery were included. Those undergoing concomitant sinus surgery were excluded. Functional nasal surgery. SOS and NOSE scores were collected at 2, 4, 6, 12, and 24 months postoperatively. Patients undergoing nasal surgery had statistically and clinically significant improvement in NOSE score at 24 months (mean improvement 29.0 points, < 0.0001). Patients with snoring history also had significant improvement in SOS score through 24 months (mean improvement 10.7 points, < 0.0001). Nonsnorers demonstrated no significant change. OSA patients achieved clinically significant improvement in SOS scores through 24 months (mean improvement 31.9; > 0.05, minimum clinically important difference = 7.6 points). Nasal surgery improves long-term nasal obstruction as measured by NOSE score and, for those with comorbid snoring and OSA, can lead to a sustained improvement in snoring-related quality of life (QOL) based on SOS score. Nonsnorers did not have a significant change in snoring symptoms. SOS can be used as a practical and effective instrument to measure snoring-related QOL outcomes after nasal airway surgery. Future studies using objective measures of snoring are needed to quantify the physiologic change in snoring after treatment of nasal obstruction. 2c.
睡眠呼吸障碍(SDB)是一种与严重的合并症相关的与睡眠相关的疾病谱。已经证明鼻气道手术可以改善 SDB,但没有大规模的研究描述手术对患者对打鼾和鼻阻塞感知的长期影响。为了描述 SDB 患者接受鼻手术后的纵向打鼾症状和鼻阻塞情况,按打鼾或阻塞性睡眠呼吸暂停(OSA)的病史进行分层。在这项前瞻性队列研究中,2013 年至 2017 年间在一家三级学术中心接受鼻手术的患者在术后 24 个月内通过打鼾结果调查(SOS)和鼻腔阻塞症状评估(NOSE)问卷进行调查。分析了患者的人口统计学、打鼾史、OSA 诊断和先前的鼻部手术。共招募了 625 名患者,其中 325 名女性(52.0%),平均年龄为 36.3 岁(标准差 15.6),74.9%的患者有打鼾( = 468),10.7%的患者有 OSA( = 67)。纳入了接受双功能性和美容鼻中隔成形术加或不加鼻甲手术的患者。排除了同时接受鼻窦手术的患者。功能性鼻手术。SOS 和 NOSE 评分在术后 2、4、6、12 和 24 个月收集。接受鼻部手术的患者在 24 个月时 NOSE 评分有统计学和临床显著改善(平均改善 29.0 分, < 0.0001)。有打鼾史的患者在 24 个月时的 SOS 评分也有显著改善(平均改善 10.7 分, < 0.0001)。无打鼾者无明显变化。OSA 患者在 24 个月时的 SOS 评分达到临床显著改善(平均改善 31.9; > 0.05,最小临床重要差异 = 7.6 分)。鼻手术可长期改善鼻腔阻塞,在合并打鼾和 OSA 的患者中,可使打鼾相关生活质量(QOL)持续改善(SOS 评分)。无打鼾者的打鼾症状无明显变化。SOS 可作为一种实用有效的工具,用于测量鼻气道手术后与打鼾相关的 QOL 结果。需要使用客观的打鼾测量方法来量化治疗鼻阻塞后打鼾的生理变化。