Korean J Otorhinolaryngol-Head Neck Surg.  2023 Oct;66(10):663-669. 10.3342/kjorl-hns.2022.00640.

Deviated Nasal Septum and Inferior Turbinate Hypertrophy: Are They the Independent Cause of Sleep-Related Breathing Disorders?

• Yun JM
• Jo YS
• Choi IS

• KMID: 2547164
• DOI: http://doi.org/10.3342/kjorl-hns.2022.00640

Abstract

Background and Objectives
Nasal obstruction has been assumed to be correlated with sleep-related breathing disorder (SRBD). However, a definite correlation between nasal obstruction and SRBD is still controversial. This study aimed to define whether symptoms and severity of the deviated septum of nose (DSN) and inferior turbinate hypertrophy (ITH) are correlated with the severity of SRBD.
Subjects and Method
This is a retrospective study of 60 patients’ preoperative polysomnography who have undergone septoplasty and turbinoplasty. Patients with obesity, tonsillar hypertrophy, high Mallampati class, mandibular problem, and nasal polyp or concha bullosa were excluded from the analysis. Subjective nasal obstruction scores, and DSN/ITH grades were collected, and correlations between apnea-hypopnea index (AHI), lowest oxygen saturation, and snoring time were analyzed.
Results
The average of AHI, lowest saturation and relative snoring time were 3.72±5.79, 89.78%±6.81%, and 8.45%±10.43%, respectively. The number of patients who were normal, obstructive sleep apnea (OSA) syndrome mild, moderate, and severe were 49 (82%), 6 (10%), 4 (7%) and 1 (1%), respectively. The degrees of DSN and ITH, and subjective nasal congestion scores showed no significant correlation with polysomnographic results. Age and AHI had a correlation coefficient of 0.54 (p<0.001) and AHI increased with increasing age. Multiple linear regression demonstrated that age (regression coefficient 0.229, 95% confidence interval 0.135 to 0.322, p<0.001) was significantly associated with AHI, while other variables showed no statistically significant association with AHI (p>0.05).
Conclusion
Septal deviation and turbinate hypertrophy are unlikely to cause OSA/snoring independently without other causes of SRBD.

Keyword

Nasal obstruction; Nasal septum; Polysomnography; Sleep apnea syndromes; Snoring