Moderate OSAS and turbinate decongestion: Surgical efficacy in improving the quality of life and compliance of CPAP using Epworth score and SNOT-20 score

Emanuele Scarano, Pasqualina Maria Picciotti, Gaetano Paludetti, Antonella Fiorita, Rodolfo Franceso Mastrapasqua, Antonella Loperfido

Risultato della ricerca: Contributo in rivistaArticolo in rivista

3 Citazioni (Scopus)

Abstract

Drug-induced sleep endoscopy (DISE) is an important procedure in diagnostic pathway of patients affected by moderate OSAS. However, the Italian National Health System does not provide any compatible Diagnosis-related-group (DRG) code codification for DISE, which makes it impossible to obtain regional reimbursement. In order to overcome this problem, DISE is usually associated with other codified surgical procedures. The aim of our study is to assess the association of turbinate decongestion (TD) and DISE in order to combine in a single operating session diagnostic and therapeutic procedures. The objective of our work is to assess the role of nasal surgery on symptoms of moderate OSA. Recent studies have confirmed that isolated nasal surgery improves quality of life (QOL), but not the apnoea hypopnoea index (AHI) during polygraph registration. We enrolled 30 patients, aged between 29 and 64 years (mean 50.53 ± 9.20), 26 males and 4 females, with a mean BMI of 26.07 ± 2.81 kg/m2, who were affected by moderate OSAS. All patients underwent otolaryngologycal pre-operative evaluation, home respiratory polygraph and subjective evaluation through Sino-Nasal-Outcome Test (SNOT-20) and Epworth Sleepiness Scale (ESS). During the same surgery session, they underwent DISE and TD. Patients were re-evaluated six months later using the same questionnaires. We observed a significant improvement (p < 0.05) in both the mean ESS index (6.03 ± 2.75 vs 4.16 ± 4.63) and total SNOT score (22.53 ± 12.16 vs 13.23 ± 10.82). Significant differences (p < 0.05) were also identified for partial SNOT questions 1-11 (9.1 ± 5.11 vs 6.13 ± 4.12) and 11-20 (13.36 ± 10.20 vs 7.13 ± 9.644). The results of the present study confirm that TD alone can improve sleepiness, QOL and nasal symptoms. Thus, in absence of a National Health System recognition for DISE, the association of this procedure with TD can be useful for diagnostic and therapeutic management of OSAS, improving CPAP compliance and adherence, reducing sleepiness, ameliorating nasal symptoms and therefore QOL.
Lingua originaleEnglish
pagine (da-a)214-221
Numero di pagine8
RivistaActa Otorhinolaryngologica Italica
Volume38
DOI
Stato di pubblicazionePubblicato - 2018

Keywords

  • Adult
  • Continuous Positive Airway Pressure
  • DISE (drug induced sleep endoscopy)
  • Diagnostic Self Evaluation
  • Epworth score
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Nasal Surgical Procedures
  • OSAS (obstructive sleep apnoea syndrome)
  • Patient Compliance
  • Prospective Studies
  • QOL (quality of life)
  • Quality of Life
  • SNOT-20 score
  • Severity of Illness Index
  • Sleep Apnea, Obstructive
  • Treatment Outcome
  • Turbinates

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