Does nasal surgery improve multilevel surgical outcome in obstructive sleep apnea:A multicenter study on 735 patients
Por:
Pang KP, Montevecchi F, Vicini C, Carrasco-Llatas M, Baptista PM, Olszewska E, Braverman I, Kishore S, Chandra S, Yang HC, Chan YH, Pang SB, Pang KA, Pang EB and Rotenberg B
Publicada:
1 dic 2020
Ahead of Print:
1 oct 2020
Resumen:
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.
Filiaciones:
Pang KP:
Otolaryngology Asia Sleep Centre, Paragon Singapore Singapore
Montevecchi F:
Ospedeli Privati Forli Forli Italy
Vicini C:
Ospedeli Privati Forli Forli Italy
:
ENT Department Hospital Universitario Dr. Peset Valencia Spain
Baptista PM:
Otolaryngology Clinica Universidad de Navarra Pamplona Navarra Spain
Olszewska E:
Sleep Apnea Surgery Center, ENT Medical University of Bialystok Bialystok Poland
Braverman I:
Otolaryngology Head and Neck Surgery, Hillel Yaffe Medical Center Technion Faculty Medicine Haifa Israel
Kishore S:
Otolaryngology Nova Specialty Hospital Hyderabad India
Chandra S:
ENT Belle Vue Clinic & Hospital Kolkata India
Yang HC:
Otolaryngology Chonnam National University Medical School Gwangju South Korea
Chan YH:
Biostatistics Unit, Yong Loo Lin School of Medicine National University Singapore Singapore Singapore
Pang SB:
Otolaryngology Asia Sleep Centre, Paragon Singapore Singapore
Pang KA:
Medicine Faculty National University Singapore Singapore Singapore
Pang EB:
Medicine Faculty University of Glasgow Glasgow UK
Rotenberg B:
Otolaryngology Western University London Ontario Canada
Green Published, gold
|