Identifying Obstructive Sleep Apnoea in Patients with Empty Nose Syndrome
Obstructive sleep apnoea (OSA) is characterised by repetitive episodes of upper airway collapse and breathing cessation during sleep. Empty nose syndrome (ENS) is a surgically iatrogenic phenomenon of paradoxical nasal obstruction despite an objectively patent nasal airway. This study aimed to inves...
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MDPI AG
2022-07-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/7/1720 |
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| author | Chien-Chia Huang Pei-Wen Wu Chi-Cheng Chuang Cheng-Chi Lee Yun-Shien Lee Po-Hung Chang Chia-Hsiang Fu Chi-Che Huang Ta-Jen Lee |
| author_facet | Chien-Chia Huang Pei-Wen Wu Chi-Cheng Chuang Cheng-Chi Lee Yun-Shien Lee Po-Hung Chang Chia-Hsiang Fu Chi-Che Huang Ta-Jen Lee |
| author_sort | Chien-Chia Huang |
| collection | DOAJ |
| description | Obstructive sleep apnoea (OSA) is characterised by repetitive episodes of upper airway collapse and breathing cessation during sleep. Empty nose syndrome (ENS) is a surgically iatrogenic phenomenon of paradoxical nasal obstruction despite an objectively patent nasal airway. This study aimed to investigate sleep quality and the presence of OSA in ENS patients. Forty-eight ENS patients underwent full-night polysomnography. Total nasal resistance (TNR) was determined using anterior rhinomanometry. Symptoms and quality of life were evaluated by the empty nose syndrome 6-item questionnaire (ENS6Q), Sino-Nasal Outcome Test-22 (SNOT-22), and Epworth Sleepiness Scale questionnaires (ESS). Fourteen, twelve, and fourteen patients had mild, moderate, and severe OSA, respectively. The apnoea–hypopnoea index (AHI) and the lowest SpO<sub>2</sub> were 23.8 ± 22.4/h and 85.9 ± 11.1%, respectively. N1, N2, N3 and rapid-eye-movement sleep comprised 30.2 ± 16.9%, 47.3 ± 15.5%, 2.1 ± 5.4%, and 20.0 ± 8.1% of the total sleep time. Body mass index, neck circumference, serum total immunoglobulin E, and ENS6Q score were significantly associated with AHI in the regression analysis. The ENS6Q scores correlated positively with AHI, arousal index, and ESS score, but negatively with TNR. ENS patients showed a high OSA prevalence and significant sleep impairment. The extent of OSA was associated with obesity levels and ENS symptom severity. The ENS6Q scores correlated negatively with nasal resistance, and positively with arousal frequency and daytime sleepiness. The recognition of individuals experiencing marked OSA and provision of appropriate intervention is critical to preventing long-term morbidity and mortality, and improving therapeutic outcomes in ENS patients. |
| first_indexed | 2024-03-09T03:31:28Z |
| format | Article |
| id | doaj.art-67ecb0f0bf2a4d8b954b997c4b0030c3 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T03:31:28Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-67ecb0f0bf2a4d8b954b997c4b0030c32023-12-03T14:55:14ZengMDPI AGDiagnostics2075-44182022-07-01127172010.3390/diagnostics12071720Identifying Obstructive Sleep Apnoea in Patients with Empty Nose SyndromeChien-Chia Huang0Pei-Wen Wu1Chi-Cheng Chuang2Cheng-Chi Lee3Yun-Shien Lee4Po-Hung Chang5Chia-Hsiang Fu6Chi-Che Huang7Ta-Jen Lee8Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital, Taoyuan 33382, TaiwanDivision of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital, Taoyuan 33382, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital, Taoyuan 33382, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital, Taoyuan 33382, TaiwanGenomic Medicine Research Core Laboratory, Chang Gung Memorial Hospital, Taoyuan 33382, TaiwanDivision of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital, Taoyuan 33382, TaiwanDivision of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital, Taoyuan 33382, TaiwanDivision of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital, Taoyuan 33382, TaiwanDivision of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital, Taoyuan 33382, TaiwanObstructive sleep apnoea (OSA) is characterised by repetitive episodes of upper airway collapse and breathing cessation during sleep. Empty nose syndrome (ENS) is a surgically iatrogenic phenomenon of paradoxical nasal obstruction despite an objectively patent nasal airway. This study aimed to investigate sleep quality and the presence of OSA in ENS patients. Forty-eight ENS patients underwent full-night polysomnography. Total nasal resistance (TNR) was determined using anterior rhinomanometry. Symptoms and quality of life were evaluated by the empty nose syndrome 6-item questionnaire (ENS6Q), Sino-Nasal Outcome Test-22 (SNOT-22), and Epworth Sleepiness Scale questionnaires (ESS). Fourteen, twelve, and fourteen patients had mild, moderate, and severe OSA, respectively. The apnoea–hypopnoea index (AHI) and the lowest SpO<sub>2</sub> were 23.8 ± 22.4/h and 85.9 ± 11.1%, respectively. N1, N2, N3 and rapid-eye-movement sleep comprised 30.2 ± 16.9%, 47.3 ± 15.5%, 2.1 ± 5.4%, and 20.0 ± 8.1% of the total sleep time. Body mass index, neck circumference, serum total immunoglobulin E, and ENS6Q score were significantly associated with AHI in the regression analysis. The ENS6Q scores correlated positively with AHI, arousal index, and ESS score, but negatively with TNR. ENS patients showed a high OSA prevalence and significant sleep impairment. The extent of OSA was associated with obesity levels and ENS symptom severity. The ENS6Q scores correlated negatively with nasal resistance, and positively with arousal frequency and daytime sleepiness. The recognition of individuals experiencing marked OSA and provision of appropriate intervention is critical to preventing long-term morbidity and mortality, and improving therapeutic outcomes in ENS patients.https://www.mdpi.com/2075-4418/12/7/1720empty nose syndrome 6-item questionnaireempty nose syndromeobstructive sleep apnoeapolysomnographysleep quality |
| spellingShingle | Chien-Chia Huang Pei-Wen Wu Chi-Cheng Chuang Cheng-Chi Lee Yun-Shien Lee Po-Hung Chang Chia-Hsiang Fu Chi-Che Huang Ta-Jen Lee Identifying Obstructive Sleep Apnoea in Patients with Empty Nose Syndrome Diagnostics empty nose syndrome 6-item questionnaire empty nose syndrome obstructive sleep apnoea polysomnography sleep quality |
| title | Identifying Obstructive Sleep Apnoea in Patients with Empty Nose Syndrome |
| title_full | Identifying Obstructive Sleep Apnoea in Patients with Empty Nose Syndrome |
| title_fullStr | Identifying Obstructive Sleep Apnoea in Patients with Empty Nose Syndrome |
| title_full_unstemmed | Identifying Obstructive Sleep Apnoea in Patients with Empty Nose Syndrome |
| title_short | Identifying Obstructive Sleep Apnoea in Patients with Empty Nose Syndrome |
| title_sort | identifying obstructive sleep apnoea in patients with empty nose syndrome |
| topic | empty nose syndrome 6-item questionnaire empty nose syndrome obstructive sleep apnoea polysomnography sleep quality |
| url | https://www.mdpi.com/2075-4418/12/7/1720 |
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