Nasal surgery for snoring in patients with obstructive sleep apnea

OBJECTIVE: To evaluate the efficacy of nasal surgery to relieve snoring and to identify predictive factors. STUDY DESIGN: Prospective comparative study. METHODS: Fifty-two consecutive patients (51 males; mean age, 38 yr; body mass index, 25.4 ± 5.2 kg/m) were enrolled. All patients had been previously diagnosed with obstructive sleep apnea (apnea/hypopnea index, 38.5 ± 33.2 events/hr) and symptomatic nasal obstruction secondary to deviated nasal septum. Septomeatoplasty alone was the treatment in this study cohort. Snoring was assessed by Snore Outcome Survey (SOS), and nasal obstruction was assessed by visual analogue scale (VAS) and anterior rhinomanometry at baseline and approximately 3 months after nasal surgery. RESULTS: Body mass index remained unchanged (P > .05) after surgery. Significantly improved SOS (P < .001), VAS (P < .001), and total nasal resistance (P = .002) were noted after nasal surgery. Eighty-six percent of patients had improved SOS scores, and average improvement was 46%. Complete relief of snoring was reported by the sleep partners of six (12%) patients. Change in SOS scores (22.5 ± 14.5 vs. 10.1 ± 10.4) significantly differed (P = .01) between tonsil size grade (TON) 0/I and TON II/III groups. Other baseline variables did not significantly differ (P > .05) in SOS score changes. CONCLUSIONS: In patients with obstructive sleep apnea suffering from both snoring and nasal obstruction, nasal surgery for deviated septum relieves snoring in 12%. The tonsil size affects the outcome of nasal surgery for snoring.