Impact of Nasal Surgery on Sleep Apnea Severity and Quality of Life: A Systematic Review

Background: Sleep breathing disorders such as obstructive sleep apnea (OSA) remain a significant concern that has a pronounced impact on the quality of life of the affected individuals. Among OSA patients, the majority of the individuals have septal deviation. Septoplasty, with or without turbinoplasty, is frequently performed to correct nasal obstruction. However, the impact of these procedures on sleep apnea outcomes remains controversial. This systematic review aims to evaluate the effects of septoplasty, with or without turbinoplasty, on the severity and quality of life in patients with OSA. Methods: A systematic search was conducted in PubMed, Web of Science, and Google Scholar. Included studies involved children and adults diagnosed with OSA undergoing septoplasty with or without turbinoplasty. Primary outcomes were the apnea–hypopnea index (AHI), Epworth Sleepiness Scale (ESS), and respiratory disturbance index. Results: A total of 10 studies with 517 participants were included. Most studies (60%) used prospective study design. A significant reduction in AHI was observed in four studies, whereas three studies did not find a significant change in AHI outcome after surgery. All of the studies that reported ESS outcomes found significant reductions in ESS following surgical intervention. Oxygen saturation did not significantly change postsurgery in any of the included studies. A significant reduction in nasal blockage was noted in three studies. Conclusion: Septoplasty, with or without turbinoplasty, may reduce the severity of sleep apnea in mild OSA patients with nasal obstruction. However, the evidence found in the present systematic review has various limitations which limits the ability to draw precise conclusions.