关键词: 睡眠呼吸暂停综合征, 鼻塞, 外科手术

Abstract: Objective: To evaluate the effect of operation for improving ventilation of nose in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: The Epworth sleepiness scale（ESS） and polysomnography(PSG) were assessed pre and postoperatively in 71 OSAHS patients with nasal anatomical stricture by using a flexible fiberoptic endoscope and a video recorder equipment, and septal surgery with or without inferior turbinectomy was performed. Results: ESS decreased from 14.8±5.2 to 9.7±4.6 after surgery (t=6.19, P=0.00). According to the results of postoperative polysomnography, 8 cases in evident efficiency, 29 efficiency and 34 nonefficiency. Improvements in sleep architecture were observed after nasal surgery, and there was a significant reduction in awakening and nonrapid eye movement (NREM) sleep 1 phase, but a significantly increase in NREM sleep 1 phase and rapid eye movement (REM)sleep phase（P＜0.01）. There were no significant changes in NREM 3+4 phase（P＞0.05）. Nasal surgery resulted in a significant decrease in apnea index (AI), hypopnea index (HI), microarousal index and snoring index, but a significant increase in lowest oxygen saturation levels (P＜0.01). The number of apnea and hypopnea episodes per hour and the body mass index (BMI) did not change significantly (P＞0.05). Conclusion: Nasal surgery has a limited efficacy in adult patients with OSAHS. Correction of the obstructed nasal airway should certainly be included in the overall treatment for OSAHS. The secondary surgery (such as uvulopalatoplasty) may be considered after a thorough evaluation by postoperative PSG .

Key words: Nasal obstruction, Surgical procedures, Sleep apnea syndromes, operative