Department of Otolaryngology, Massachussetts Eye and Ear, Boston, Massachussetts, USA.
Department of Otolaryngology, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey.
Facial Plast Surg Aesthet Med. 2020 Nov/Dec;22(6):412-419. doi: 10.1089/fpsam.2020.0005. Epub 2020 May 19.
Functional septorhinoplasty (FSRP) has been shown to improve both global and disease-specific quality of life (QOL). However, the mechanism by which FSRP improves QOL has not been fully defined. We reasoned that NAO may impact sleep quality and, therefore, studied the relationship using validated patient-reported outcome measures. To investigate the correlation between NAO and sleep quality using Nasal Obstruction Symptom Evaluation (NOSE) and Functional Outcomes of Sleep Quality (FOSQ-10) questionnaires, and to evaluate the effect of FSRP on NAO and sleep quality. This is a prospective longitudinal study of 125 patients undergoing FSRP for the repair of NAO between November 2017 and April 2019 in a university-based tertiary care medical center. The individuals (mean age = 38 ± 15.6 years, 65 females; 52%) were invited to complete the FOSQ-10 survey preoperatively and at 2, 4, 6, and 12 months postoperatively, and 122 of these patients also completed the NOSE questionnaire. Sixty individuals who reported a history of snoring also completed the Snoring Outcomes Survey (SOS). Twelve of 125 patients had obstructive sleep apnea. Patient demographics, nasal surgery, and medical histories and outcomes were analyzed. Functional septorhinoplasty. Comparison of pre- and postoperative sleep and NAO scores to determine the correlation between the severity of NAO and sleep quality and the impact of correction of NAO on sleep quality. A total of 125 patients completed FOSQ-10 questionnaire with a median score of 18.00 (IQR = 15.33-19.66) at baseline. Among these individuals, 122 patients completed the NOSE questionnaire with a median score of 65 (IQR = 45-75). A negative correlation between NOSE and FOSQ-10 scores was found at baseline ( = -0.380, < 0.001). There was a significant difference in baseline FOSQ-10 scores between individuals with ( = 12, mean FOSQ-10 score = 13.28 ± 3.19) ( < 0.001) and without sleep apnea ( = 100, mean FOSQ-10 score = 17.24 ± 3.21). After FSRP, the NOSE and FOSQ-10 scores improved at each postoperative follow-up time point. The change in FOSQ-10 scores was statistically significant at months 2, 4, and 6 ( < 0.001) but not at month 12 ( = 0.161). The NOSE scores were statistically different from baseline level for each postoperative follow-up visits ( < 0.001-months 2, 4, and 6 and = 0.031-month 12). The distribution of NOSE scores was not different statistically ( = 0.984). The negative correlation between NOSE and FOSQ-10 mean scores that was demonstrated at baseline increases postoperatively ( = 0.508, < 0.001). FSRP can improve both symptoms of NAO and sleep quality. The increased correlation between NAO and sleep quality after surgery is consistent with the hypothesis that improvement in NAO improves sleep quality and QOL.
功能性鼻中隔成形术（FSRP）已被证明可以提高整体和疾病特异性生活质量（QOL）。然而，FSRP 改善 QOL 的机制尚未完全确定。我们推测，NAO 可能会影响睡眠质量，因此，我们使用经过验证的患者报告的结果测量工具来研究这种关系。
为了使用鼻腔阻塞症状评估（NOSE）和睡眠质量的功能结果（FOSQ-10）问卷来研究 NAO 和睡眠质量之间的相关性，并评估 FSRP 对 NAO 和睡眠质量的影响。这是一项前瞻性纵向研究，纳入了 2017 年 11 月至 2019 年 4 月在一所大学三级护理医疗中心接受 FSRP 修复 NAO 的 125 例患者。这些个体（平均年龄 38 ± 15.6 岁，女性 65%；52%）被邀请在术前和术后 2、4、6 和 12 个月完成 FOSQ-10 调查，其中 122 例患者还完成了 NOSE 问卷。60 名报告有打鼾史的患者还完成了打鼾结局调查（SOS）。125 例患者中有 12 例患有阻塞性睡眠呼吸暂停。分析了患者的人口统计学、鼻手术、医疗史和结果。
功能性鼻中隔成形术。
比较术前和术后睡眠和 NAO 评分，以确定 NAO 严重程度与睡眠质量之间的相关性，以及纠正 NAO 对睡眠质量的影响。
共有 125 例患者完成了 FOSQ-10 问卷，中位数得分为 18.00（IQR=15.33-19.66）。其中 122 例患者完成了 NOSE 问卷，中位数得分为 65（IQR=45-75）。在基线时，NOSE 和 FOSQ-10 评分之间存在负相关（= -0.380，<0.001）。在基线时，有和没有睡眠呼吸暂停的患者的 FOSQ-10 评分存在显著差异（= 12，平均 FOSQ-10 评分= 13.28 ± 3.19）（<0.001）。
在 FSRP 后，NOSE 和 FOSQ-10 评分在每次术后随访时都有所改善。在第 2、4 和 6 个月时（<0.001），FOSQ-10 评分的变化具有统计学意义，但在第 12 个月时（= 0.161）则没有。NOSE 评分在每次术后随访时均与基线水平有统计学差异（<0.001-第 2、4 和 6 个月，= 0.031-第 12 个月）。NOSE 评分的分布没有统计学差异（= 0.984）。在基线时表现出的 NOSE 和 FOSQ-10 平均评分之间的负相关在术后增加（= 0.508，<0.001）。
FSRP 可以改善 NAO 症状和睡眠质量。术后 NAO 和睡眠质量之间增加的相关性与改善 NAO 可改善睡眠质量和 QOL 的假设一致。
