Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Laryngoscope. 2023 Aug;133(8):2029-2034. doi: 10.1002/lary.30730. Epub 2023 May 9.
Approximately 20% of patients with chronic rhinosinusitis (CRS) have comorbid obstructive sleep apnea (OSA). Patients with undiagnosed OSA are at high risk for perioperative complications. The Sinonasal Outcomes Test (SNOT-22) Questionnaire is commonly administered to CRS patients, whereas OSA screening tools are less routinely employed. This study compared SNOT-22 sleep subdomain (Sleep-SNOT) scores among non-OSA CRS versus OSA-CRS patients undergoing ESS, and assessed sensitivity, specificity, and diagnostic accuracy of the Sleep-SNOT for OSA screening.
Retrospective review of patients that underwent endoscopic sinus surgery (ESS) for CRS from 2012 to 2021. Patients either carried a reported OSA diagnosis and completed the SNOT-22, or had undocumented OSA status and completed both STOP-BANG and SNOT-22. Demographics, questionnaire scores, and OSA status were collected. A receiver operating characteristic (ROC) curve assessed cutoff scores, sensitivity, and specificity of the Sleep-SNOT for OSA screening.
Of 600 patients reviewed, 109 were included. 41% had comorbid OSA. OSA patients had a higher BMI (32.1 ± 7.7 vs. 28.35 ± 6.7 kg/m ; p = 0.02), Sleep-SNOT (21.96 ± 12.1 vs. 16.8 ± 11.2; p = 0.021) and STOP-BANG (3.1 ± 1.44 vs. 2.06 ± 1.27; p = 0.038) scores. A Sleep-SNOT score of 17.5 had a sensitivity of 68.9%, specificity of 55.7%, and diagnostic accuracy of 63% for OSA detection (p = 0.022).
Sleep-SNOT scores are greater for CRS-OSA patients. The Sleep-SNOT ROC curve demonstrates a high sensitivity, specificity, and accuracy for OSA screening in CRS patients. A Sleep-SNOT score of ≥17.5 should prompt further OSA evaluation. The Sleep-SNOT may be considered as a surrogate OSA screening tool when other validated tools are not employed.
Retrospective chart review, Level 3 Laryngoscope, 133:2029-2034, 2023.
约 20%的慢性鼻-鼻窦炎（CRS）患者合并阻塞性睡眠呼吸暂停（OSA）。未诊断出 OSA 的患者有发生围手术期并发症的高风险。鼻窦-鼻息肉结局测试 22 项量表（SNOT-22）常用于 CRS 患者，但 OSA 筛查工具的应用则不那么常规。本研究比较了接受内镜鼻窦手术（ESS）治疗的非 OSA-CRS 与 OSA-CRS 患者的 SNOT-22 睡眠亚域（Sleep-SNOT）评分，并评估了 Sleep-SNOT 筛查 OSA 的敏感性、特异性和诊断准确性。
回顾性分析 2012 年至 2021 年接受 ESS 治疗的 CRS 患者。患者要么有报告的 OSA 诊断并完成了 SNOT-22，要么无 OSA 记录且完成了 STOP-BANG 和 SNOT-22。收集患者的人口统计学、问卷评分和 OSA 状况等数据。受试者工作特征（ROC）曲线评估了 Sleep-SNOT 筛查 OSA 的截断值评分、敏感性和特异性。
在 600 名接受评估的患者中，有 109 名患者符合纳入标准。其中 41%合并 OSA。OSA 患者的 BMI（32.1±7.7 与 28.35±6.7kg/m；p=0.02）、Sleep-SNOT（21.96±12.1 与 16.8±11.2；p=0.021）和 STOP-BANG（3.1±1.44 与 2.06±1.27；p=0.038）评分均更高。Sleep-SNOT 评分≥17.5 对 OSA 检测的敏感性为 68.9%，特异性为 55.7%，诊断准确性为 63%（p=0.022）。
CRS-OSA 患者的 Sleep-SNOT 评分更高。Sleep-SNOT 的 ROC 曲线显示，在 CRS 患者中，该评分对 OSA 筛查具有较高的敏感性、特异性和准确性。Sleep-SNOT 评分≥17.5 应提示进一步进行 OSA 评估。当其他经过验证的工具未被应用时，Sleep-SNOT 可作为替代 OSA 筛查工具。
回顾性图表审查，Laryngoscope 杂志 133 卷，第 10 期，2029-2034 页，2023 年。
