Publicaciones científicas

Does nasal surgery improve multilevel surgical outcome in obstructive sleep apnea: A multicenter study on 735 patients

08-oct-2020 | Revista: Laryngoscope Investigative Otolaryngology

Kenny P Pang  1 , Filippo Montevecchi  2 , Claudio Vicini  2 , Marina Carrasco-Llatas  3 , Peter M Baptista  4 , Ewa Olszewska  5 , Itzhak Braverman  6 , Srivinas Kishore  7 , Sudipta Chandra  8 , Hyung Chae Yang  9 , Yiong Huak Chan  10 , Scott B Pang  1 , Kathleen A Pang  11 , Edward B Pang  12 , Brian Rotenberg  13


Objective: Does nasal surgery affect multilevel surgical success outcome.

Methods: Prospective eight country nonrandomized trial of 735 obstructive sleep apnea (OSA) patients, who had multilevel palate and/or tongue surgery, divided into two groups, with or without nose surgery.

Results: There were 575 patients in nose group, 160 patients in no nose group. The mean age for nose group 44.6 ± 11.4, no nose group 44.2 ± 11.8. Mean preoperative BMI for nose group 27.5 ± 3.6, no nose group 27.5 ± 4.1, mean postoperative BMI nose group 26.3 ± 3.7, no nose group 27.1 ± 3.8 (P = .006).

Mean preoperative AHI nose group 32.7 ± 19.4, no nose group 34.3 ± 25.0 (P = .377); and mean postoperative AHI nose group 13.5 ± 10.2, no nose group 17.1 ± 16.0 (P = .001). Mean preoperative ESS nose group was 11.3 ± 4.7, no nose group was 10.4 ± 5.4 (P = .051); and mean postoperative ESS nose group was 5.3 ± 3.2, no nose group was 6.7 ± 2.8 (P = .001). The nose group had higher percentage change (adjusted for age, gender, BMI) in AHI (33.7%, 95% CI 14% to 53.5%) compared to the no nose group (P = .001); the nose group also had more percentage change in ESS (37%, 95% CI 23.6% to 50.3%) compared to the no nose group (P < .001). Change in BMI did not affect AHI nor ESS change (Cohen effect 0.03 and 0.14, respectively). AHI change in both groups were also statistically significant in the mild OSA (P = .008) and the severe OSA (P = .01). Success rate of surgery for the nose group 68.2%, while the no nose group 55.0% (P = .002).

Conclusion: Combining nose surgery in multilevel surgery improves surgical success.

CITA DEL ARTÍCULO  Laryngoscope Investig Otolaryngol. 2020 Oct 8;5(6):1233-1239.  doi: 10.1002/lio2.452. eCollection 2020 Dec.