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Abstract
Background: Nasal obstruction is associated with snoring, sleep disordered breathing, and OSA. Abnormal nasal physiology is an important aspect of OSA etiology.
Aims/objectives: To perform a systematic review and meta-analysis to determine if isolated nasal surgery in patients with and without OSA could improve sleep quality after surgery.
Material and methods: Computerized searches were performed in PubMed, Scopus, google scholar and the Cochrane library through June 2017. Two independent investigators performed the articles searching, screening and the data extraction.
Results: There were 19 studies meeting inclusion and exclusion criteria including a total of 896 patients. These studies were divided into two subgroups depending on diagnosis with and without OSA. In subgroup OSA (n = 14), there was a significant improvement in the pooled results of Epworth Sleepiness Scale (ESS) with isolated nasal surgery. In subgroup without OSA (n = 5), the pooled mean difference of ESS before and after surgery was similar. In each subgroup, there was no significant improvement in the Apnea Hypopnea Index.
Conclusions: The pooled results showed isolated nasal and sinus surgery for patients with OSA could improve subjective sleep parameters and reduce daytime sleepiness, but had no significant improvements on objective parameters. In patients without OSA, it was ineffective to improve sleep quality.
背景：鼻阻塞与打鼾、睡眠呼吸障碍和OSA有关。鼻生理异常是OSA病因的一个重要方面。
目的：进行系统回顾和荟萃分析, 以确定单独鼻外科手术治疗OSA患者和非OSA患者, 术后是否能改善睡眠质量。
材料和方法：2017年6月, 在PubMed、Scopus、谷歌学者和Cochrane图书馆进行计算机检索。两名独立的调查人员进行了文章搜索、筛选和数据提取。
结果：共有19项符合入选和排除标准的研究, 包括896名患者。这些研究根据有或无OSA的诊断分为两个亚组。在OSA亚组（n = 14）, 单独鼻腔手术的艾普沃思嗜睡量表（ESS）综合结果有显著改善。在无OSA亚组（n = 5）, 术前和术后的ESS平均差异相似。各亚组呼吸暂停低通气指数无明显改善。
结论：单独鼻窦手术治疗OSA可改善患者的主观睡眠参数, 减少日间嗜睡, 但对客观参数无明显改善。对于非OSA患者, 改善睡眠质量没有效果。