S297 – Nasal Surgery for Obstructive Sleep Apnea Syndrome

Objectives Using evidence-based methodology, we report the literature review findings concerning nasal surgery and OSAS. Methods The MedLine, EMBRASE, Cochrane databases are searched (1960-; 2008) using subject headings “nasal surgery,” “sleep apnea,” “snoring,” or “sleep disorder.” Letters to editor, case reports, review articles, and non-English publications are excluded. Data extracted from these articles are used for critical appraisal and are analyzed using meta-analysis and data-synthesis technology. Results Patients pooling revealed gender distribution (90% male), with a mean age of 48 years, and respiratory disturbance index (RDI) ranged from 6.2 to 83.6 event/hr. Baseline BMI spanning from 25.9 to 35.7 kg/m2 was recorded in 10 articles. Total nasal resistance from 2.7 to 5.8cm H2O/L/S was measured in 5 articles. In 13 articles, nasal surgery is the only procedure that applied to patients. 5 articles report significant improvement in AHI; 2 of nasal-surgery only and 3 of nasal with oropharyngeal surgery. The success rate was statistically significant between “nasal surgery-only” and “nasal with oropharynx surgeries-together” articles (15.8–57% vs 40–82%, P=0.03). Although significant improvement in nasal obstruction and concomitant quality of life were mentioned in aforementioned articles, there were no universal measures to present a coherent analysis. Conclusions Nasal surgery might be efficacious in treating OSAS-related symptoms. However, the meta-analysis does not support the efficacy of exclusive nasal surgery for sleep apnea in regard to the success rate. Heterogeneity in small study population and incoherence of outcomes measures limit the study and warrant further research.