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Improvement in Quality of Life After Nasal Surgery Alone for Patients With Obstructive Sleep Apnea and Nasal Obstruction
Hsueh-Yu Li, MD;
Ying Lin, BS;
Ning-Hung Chen, MD;
Li-Ang Lee, MD;
Tuan-Jen Fang, MD;
Pa-Chun Wang, MD, MSc
Arch Otolaryngol Head Neck Surg. 2008;134(4):429-433.
Objective To evaluate the impact of nasal surgery alone on quality of life (QOL) in patients with obstructive sleep apnea and nasal obstruction using generic and disease-specific QOL questionnaires.
Design Prospective, longitudinal cohort study.
Patients Fifty-one consecutive patients with obstructive sleep apnea (50 men and 1 woman; mean age, 39 years; mean [SD] apnea-hypopnea index, 37.4 [28.9] events/h; and mean ± SD body mass index [calculated as weight in kilograms divided by height in meters squared], 26.0 [3.5]) with symptoms of nasal obstruction due to a deviated nasal septum.
Intervention Septomeatoplasty.
Outcome Measures Surgical outcomes were measured using the Snore Outcomes Survey, the Epworth Sleepiness Scale, and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) 3 months after surgery. We compared baseline and postoperative scores. Normative SF-36 data obtained from 4591 age- and sex-matched adults were used as references.
Results Nasal obstruction symptoms significantly improved (mean [SD] visual analog scale score, –5.2 [1.4]; P < .001). Assessments also showed significant improvement in the Snore Outcomes Survey (P < .001) and Epworth Sleepiness Scale (P < .001) scores and 6 of the 8 SF-36 subscale scores (P < .05). Remarkable improvements were observed in disease-specific Snore Outcomes Survey (by 43.1%), Epworth Sleepiness Scale (by 27.3%), and generic SF-36 role-emotional (by 30.4%) and role-physical (by 20.7%) QOL subscales. The postoperative role-emotional, bodily pain, and social function dimensions of health were indistinguishable from referential population data (P > .05).
Conclusions Correction of an obstructed nasal airway significantly improves disease-specific and generic QOL in adult patients with obstructive sleep apnea who also have nasal obstruction symptoms. After nasal surgery, patients may experience greater improvement in snoring and daytime sleepiness than in other generic health status. Our findings substantiate the role of nasal surgery in treating patients with obstructive sleep apnea and nasal obstruction.
Author Affiliations: Departments of Otolaryngology (Drs Li, Lee, and Fang) and Pulmonary and Critical Care Medicine (Ms Lin and Dr Chen), Sleep Center, Chang Gung Memorial Hospital, Department of Otolaryngology, Cathay General Hospital (Dr Wang), and School of Medicine, Fu Jen Catholic University (Dr Wang), Taipei, Taiwan; Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taiwan (Dr Li); Department of Sleep Medicine, Royal Infirmary Edinburgh, Edinburgh, Scotland (Dr Li); and School of Public Health, China Medical University, Taichung, Taiwan (Dr Wang).
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