{"title":"Morphology of Nasal Septal Deviation in Obstructive Sleep Apnea Patients and its Treatment Method.","authors":"Kosuke Miyamura, Daiki Nakashima, Tsuguhisa Nakayama, Kota Wada, Robson Capasso, Shintaro Chiba","doi":"10.1002/lary.31876","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Nasal septal deviation can cause nasal breathing issues, contribute to obstructive sleep apnea (OSA) development, and often hinders successful CPAP therapy. We hypothesized that although prevalent in the general population, nasal septal deviations differ structurally between OSA and non-OSA patients. This study evaluated nasal septal deviation morphology in OSA versus non-OSA patients using computed tomography (CT).</p><p><strong>Methods: </strong>We consecutively enrolled 128 adult patients undergoing septoplasty for nasal obstruction between April and September 2019. Seven with trauma/surgery history were excluded. Polysomnography was performed preoperatively for those with significant sleep complaints. Using identical preoperative sinus CTs routines, we measured anterior, superior, and posterior deviation angles, comparing OSA and non-OSA groups.</p><p><strong>Results: </strong>We studied 121 septoplasty patients (37 females, 84 males, mean age 45.73 ± 1.29 years), with 34 OSA and 87 non-OSA. Anterior deviation angle was significantly greater in OSA (mean 9.1 ± 0.7°) versus non-OSA (mean 6.5 ± 0.5°) groups (p = 0.001). However, no significant superior or posterior deviation differences existed between groups (p = 0.266 and 0.231, respectively). Multiple logistic regression showed anterior deviation as the only significant independent OSA predictive factor.</p><p><strong>Conclusion: </strong>Among the nasal septal deviations, only the anterior deviation was associated with the presence of OSA. Thus, the selection of a surgical technique for anterior deviation is an important consideration in patients with OSA.</p><p><strong>Level of evidence: </strong>3 Laryngoscope, 2024.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/lary.31876","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Nasal septal deviation can cause nasal breathing issues, contribute to obstructive sleep apnea (OSA) development, and often hinders successful CPAP therapy. We hypothesized that although prevalent in the general population, nasal septal deviations differ structurally between OSA and non-OSA patients. This study evaluated nasal septal deviation morphology in OSA versus non-OSA patients using computed tomography (CT).
Methods: We consecutively enrolled 128 adult patients undergoing septoplasty for nasal obstruction between April and September 2019. Seven with trauma/surgery history were excluded. Polysomnography was performed preoperatively for those with significant sleep complaints. Using identical preoperative sinus CTs routines, we measured anterior, superior, and posterior deviation angles, comparing OSA and non-OSA groups.
Results: We studied 121 septoplasty patients (37 females, 84 males, mean age 45.73 ± 1.29 years), with 34 OSA and 87 non-OSA. Anterior deviation angle was significantly greater in OSA (mean 9.1 ± 0.7°) versus non-OSA (mean 6.5 ± 0.5°) groups (p = 0.001). However, no significant superior or posterior deviation differences existed between groups (p = 0.266 and 0.231, respectively). Multiple logistic regression showed anterior deviation as the only significant independent OSA predictive factor.
Conclusion: Among the nasal septal deviations, only the anterior deviation was associated with the presence of OSA. Thus, the selection of a surgical technique for anterior deviation is an important consideration in patients with OSA.
目的：鼻中隔偏曲会引起鼻呼吸问题，导致阻塞性睡眠呼吸暂停（OSA）的发生，并经常阻碍 CPAP 治疗的成功。我们假设，虽然鼻中隔偏曲在普通人群中普遍存在，但 OSA 患者和非 OSA 患者的鼻中隔偏曲在结构上存在差异。本研究使用计算机断层扫描（CT）评估了 OSA 与非 OSA 患者的鼻中隔偏曲形态：2019年4月至9月期间，我们连续招募了128名因鼻阻塞而接受鼻中隔成形术的成年患者。排除了 7 名有外伤/手术史的患者。术前对有明显睡眠不适的患者进行多导睡眠图检查。使用相同的术前鼻窦 CT，我们测量了前偏角、上偏角和后偏角，并对 OSA 组和非 OSA 组进行了比较：我们对 121 名鼻中隔成形术患者（37 名女性，84 名男性，平均年龄 45.73 ± 1.29 岁）进行了研究，其中有 34 名 OSA 患者和 87 名非 OSA 患者。OSA 组（平均 9.1 ± 0.7°）的前偏角明显大于非 OSA 组（平均 6.5 ± 0.5°）（p = 0.001）。但是，各组之间的上偏差和后偏差没有明显差异（p = 0.266 和 0.231）。多重逻辑回归显示，前偏位是唯一显著的独立 OSA 预测因素：结论：在鼻中隔偏曲中，只有前偏曲与 OSA 存在相关性。结论：在鼻中隔偏曲中，只有前偏曲与 OSA 存在相关性。因此，选择前偏曲的手术技术是 OSA 患者的重要考虑因素：3 《喉镜》，2024 年。
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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