Skip to main content

The effect of treatment of nasal and sinus diseases on the success rate of palatal surgery for obstructive sleep apnea




Many patients with obstructive sleep apnea (OSA) have coexisting nasal and sinus problems. In the absence of major anatomical abnormalities, these problems may be overlooked, hence jeopardizing the success rate of palatal surgery. Our objective was to identify the effect of medical management of nasal and sinus diseases on the success rate of palatal surgery in mild to moderate cases of OSA.


This prospective study included 28 patients divided in two groups; group A was treated medically with antibiotics and local steroids before palatal surgeries, whereas group B was not treated medically before palatal surgeries. Assessment was made preoperatively and postoperatively using polysomnography.


Group A showed more improvement in the apnea hypopnea index than group B.


Management of nasal and sinus problems improves the results of palatal surgery in cases of mild to moderate OSA.


  1. Lugaresi E, Cirignotta F, Geraldi R, Montagna P. Snoring and sleep apnea: natural history of heavy snorers disease. In: Guilleminault C, Partinin M, editors. Obstructive sleep apnea syndrome: clinical research and treatment. New York: Raven Press; 1990. pp. 25–36.

    Google Scholar 

  2. Papsidero MJ. The role of nasal obstruction in obstructive sleep apnea syndrome. Ear Nose Throat J. 1993; 72: 82–84

    CAS  Article  Google Scholar 

  3. Shepard JW Jr, Burger CD. Nasal and oral flow-volume loops in normal subjects and patients with obstructive sleep apnea. Am Rev Respir Dis. 1990;142(Pt 1):1288–1293

    Article  Google Scholar 

  4. Hormann K, Verse T. Surgery for sleep disordered breathing. New York: Springer; 2005.

    Google Scholar 

  5. D’Alonzo GE Jr. Scope and impact of allergic rhinitis. J Am Osteopath Assoc. 2002;102(Suppl 2):S2–S6

    PubMed  Google Scholar 

  6. Bhattacharyya N. The economic burden and symptom manifestations of chronic rhinosinusitis. Am J Rhinol. 2003; 17: 27–32

    Article  Google Scholar 

  7. Suratt PM, Turner BL, Wilhoit SC. Effect of intranasal obstruction on breathing during sleep. Chest. 1986; 90: 324–329

    CAS  Article  Google Scholar 

  8. Bachert C, van Cauwenberge P, Khaltaev N. Allergic Rhinitis and its Impact on Asthma (ARIA). In collaboration with the World Health Organization. Executive summary of the workshop report; 7–10 December 1999; Geneva, Switzerland. Allergy. 2002;57:841–855

    CAS  Article  Google Scholar 

  9. Young T, Finn L, Kim H. Nasal obstruction as a risk factor for sleep-disordered breathing. The University of Wisconsin Sleep and Respiratory Research Group. J Allergy Clin Immunol. 1997; 99: S757–S762

    CAS  Article  Google Scholar 

  10. Craig TJ, Ferguson BJ, Krouse JH. Sleep impairment in allergic rhinitis, rhinosinusitis, and nasal polyposis. Am J Otolaryngol. 2008; 29: 209–217

    Article  Google Scholar 

  11. Miljeteig H, Hoffstein V, Cole P. The effect of unilateral and bilateral nasal obstruction on snoring and sleep apnea. Laryngoscope. 1992; 102: 1150–1152

    CAS  Article  Google Scholar 

  12. Atkins M, Taskar V, Clayton N, Stone P, Woodcock A. Nasal resistance in obstructive sleep apnea. Chest. 1994; 105: 1133–1135

    CAS  Article  Google Scholar 

  13. Desfonds P, Planès C, Fuhrman C, Foucher A, Raffestin B. Nasal resistance in snorers with or without sleep apnea: effect of posture and nasal ventilation with continuous positive airway pressure. Sleep. 1998; 21: 625–632

    CAS  Article  Google Scholar 

  14. Olsen KO, Kern EB. Nasal influences on snoring and obstructive sleep apnea. Mayo Clinic Proc. 1990; 65: 1095–1105

    CAS  Article  Google Scholar 

  15. Stradling JR, Crosby JH. Predictors and prevalence of obstructive sleep apnoea and snoring in 1001 middle aged men. Thorax. 1991; 46: 85–90

    CAS  Article  Google Scholar 

  16. Egan KK, Kezirian EJ, Kim DW. Nasal obstruction and sleep-disordered breathing. Op Teh in Otolaryng H & N Surg. 2006; 17: 268–272

    Article  Google Scholar 

  17. Verse T, Pirsig W. Impact of impaired nasal breathing on sleep-disordered breathing. Sleep Breath. 2003; 7: 63–76

    Article  Google Scholar 

  18. Kiely JL, Nolan P, McNicholas WT. Intranasal corticosteroid therapy for obstructive sleep apnea in patients with co-existing rhinitis. Thorax. 2004; 59: 50–55

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Friedman M, Tanyeri H, Lim JW, Landsberg R, Vaidyanathan K, Caldarelli D. Effect of improved nasal breathing on obstructive sleep apnea. Otolaryngol Head Neck Surg. 2000; 122: 71–74

    CAS  Article  Google Scholar 

  20. Schönhofer B, Kerl J, Suchi S, Köhler D, Franklin KA. Effect of nasal valve dilation on effective CPAP level in obstructive sleep apnea. Respir Med. 2003; 97: 1001–1005

    Article  Google Scholar 

  21. Constantian MB. Four common anatomic variants that predispose to unfavorable rhinoplasty results: a study based on 150 consecutive secondary rhinoplasties. Plast Reconstr Surg. 2000; 105: 316–331

    CAS  Article  Google Scholar 

  22. Powell NB, Riley RW, Guilleminault C, Murcia GN. Obstructive sleep apnea, continuous positive airway pressure, and surgery. Otolaryngol Head Neck Surg. 1988; 99: 362–369

    CAS  Article  Google Scholar 

  23. Series F, St Pierre S, Carrier G. Effects of surgical correction of nasal obstruction in the treatment of obstructive sleep apnea. Am Rev Respir Dis. 1992; 146: 1261–1265

    CAS  Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Nassim T. Nassim MD.

Additional information

Conflicts of interest

There are no conflicts of interest.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Nassim, N.T., Elhoshy, H.M., Fattah, A.F.A. et al. The effect of treatment of nasal and sinus diseases on the success rate of palatal surgery for obstructive sleep apnea. Egypt J Otolaryngol 28, 196–200 (2012).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • apnea hypopnea index
  • Lund–Mackay score
  • obstructive sleep apnea