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Review
. 2017 Feb;96(5):e6008.
doi: 10.1097/MD.0000000000006008.

Apnea-hypopnea index decreased significantly after nasal surgery for obstructive sleep apnea: A meta-analysis

Jun Wu  1 , Guoqiang Zhao, Yunchuan Li, Hongrui Zang, Tong Wang, Dongbo Wang, Demin Han
Affiliations
Review

Apnea-hypopnea index decreased significantly after nasal surgery for obstructive sleep apnea: A meta-analysis

Jun Wu et al. Medicine (Baltimore). 2017 Feb.

Abstract

Background: Nasal surgeries have been applied to obstructive sleep apnea (OSA) patients with nasal obstruction for decades. However, the efficiency of nasal surgery in improving OSA remains controversial.The aim of this study was to identify whether isolated nasal surgery can improve apnea-hypopnea index (AHI).

Methods: Computerized searches were performed in MEDLINE, Web of Science, Cochrane Library, and Scopus from January 1, 2000 to April 30, 2016. A total of 18 articles and 587 participants were included. There were 1 randomized controlled trials, 2 nonrandomized trials, 11 prospective studies, and 4 retrospective studies. Data regarding study design (prospective/retrospective clinical trial, randomized, and controlled), population size, participant characteristics (age, gender, and body mass index), surgical intervention, and outcomes (AHI, Epworth sleep scale [ESS]) was collected.

Results: Statistically significant improvement in AHI (subgroup 1: weighted mean difference [WMD] [95%confidence interval (CI)], -4.17 [-7.62, -0.73]; subgroup 2: WMD [95%CI], -4.19 [-7.51, -0.88]; overall: WMD [95%CI], -4.15 [-6.48, -1.82]) and ESS (subgroup 1: WMD [95%CI], -2.14 [-3.08, -1.19]; subgroup 2: WMD [95%CI], -4.70 [-5.95, -3.44]; overall: WMD [95%CI], -4.08 [-5.27, -2.88]) was revealed.

Conclusion: Both AHI and ESS improved significantly after isolated nasal surgery, but the improvement of AHI is slightly significant. Future randomized controlled trials are needed to confirm the long-term benefits of nasal surgery on OSA.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart.
Figure 2
Figure 2
Subgroup 1 includes studies providing AHI SD of outcome parameter; subgroup 2 includes studies not providing AHI SD of outcome parameter. AHI = apnea–hypopnea index, SD = standard deviation.
Figure 3
Figure 3
Subgroup 1 includes studies providing ESS SD of outcome parameter; subgroup 2 includes studies not providing ESS SD of outcome parameter. ESS = Epworth sleepiness scale, SD = standard deviation.
See this image and copyright information in PMC

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