Lisa Ishii1, Andres Godoy, Stacey L Ishman, Christine G Gourin, Masaru Ishii. 1. Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, 4949 Eastern Ave, A5W, 595A, Baltimore, MD 21224, USA. Learnes2@jhmi.edu
Abstract
OBJECTIVE: To determine if clinical data and Nasal Obstruction Symptom Evaluation (NOSE) scores can be used to identify patients at risk for obstructive sleep apnea (OSA). DESIGN: Intake surveys using the NOSE, Epworth Sleepiness Scale (ESS), and Snore Outcomes Scale (SOS) were administered to new patients visiting a facial plastic surgery practice and a rhinology practice. SETTING: An academic facial plastic surgery practice and an academic rhinology practice. PATIENTS: New patients to both practices. MAIN OUTCOME MEASURES: NOSE score and presence of septal deviation. RESULTS: The odds ratio (OR) for an ESS score higher than 10 was 2.98 (95% confidence interval [CI], 1.17-7.57) when snoring was present; 5.5 (95% CI, 1.35-22.58) when the NOSE score was 10 or higher; and 3.3 (95% CI, 0.98-11.0) when a deviated septum was found on clinical examination. The probability of an elevated ESS score was 88% when all 3 factors were present and 56% when the NOSE score was not elevated. Receiver operating characteristic analysis with predictors "snore" and NOSE score of 10 or higher had an area under the curve of 0.72. With a probability cutoff of 0.5, the sensitivity was 30%, and the specificity 90%. CONCLUSIONS: Sinonasal surgery is among the most common outpatient procedures performed in the United States each year. Many patients undergoing sinonasal surgery have undiagnosed OSA or nasal obstruction, a known risk factor for OSA. Patients with OSA have unique perioperative needs. In patients with nasal obstruction, a deviated septum, and/or snoring, there is an association between the NOSE score and the ESS score. The NOSE survey may serve as a simple screening instrument instead of the ESS for patients at risk for undiagnosed OSA and special perioperative needs.
OBJECTIVE: To determine if clinical data and Nasal Obstruction Symptom Evaluation (NOSE) scores can be used to identify patients at risk for obstructive sleep apnea (OSA). DESIGN: Intake surveys using the NOSE, Epworth Sleepiness Scale (ESS), and Snore Outcomes Scale (SOS) were administered to new patients visiting a facial plastic surgery practice and a rhinology practice. SETTING: An academic facial plastic surgery practice and an academic rhinology practice. PATIENTS: New patients to both practices. MAIN OUTCOME MEASURES: NOSE score and presence of septal deviation. RESULTS: The odds ratio (OR) for an ESS score higher than 10 was 2.98 (95% confidence interval [CI], 1.17-7.57) when snoring was present; 5.5 (95% CI, 1.35-22.58) when the NOSE score was 10 or higher; and 3.3 (95% CI, 0.98-11.0) when a deviated septum was found on clinical examination. The probability of an elevated ESS score was 88% when all 3 factors were present and 56% when the NOSE score was not elevated. Receiver operating characteristic analysis with predictors "snore" and NOSE score of 10 or higher had an area under the curve of 0.72. With a probability cutoff of 0.5, the sensitivity was 30%, and the specificity 90%. CONCLUSIONS: Sinonasal surgery is among the most common outpatient procedures performed in the United States each year. Many patients undergoing sinonasal surgery have undiagnosed OSA or nasal obstruction, a known risk factor for OSA. Patients with OSA have unique perioperative needs. In patients with nasal obstruction, a deviated septum, and/or snoring, there is an association between the NOSE score and the ESS score. The NOSE survey may serve as a simple screening instrument instead of the ESS for patients at risk for undiagnosed OSA and special perioperative needs.
Authors: John S Rhee; Corbin D Sullivan; Dennis O Frank; Julia S Kimbell; Guilherme J M Garcia Journal: JAMA Facial Plast Surg Date: 2014 May-Jun Impact factor: 4.611
Authors: D S Heath; H El-Hakim; Y Al-Rahji; E Eksteen; T C Uwiera; A Isaac; M Castro-Codesal; C Gerdung; J Maclean; P J Mandhane Journal: J Otolaryngol Head Neck Surg Date: 2021-07-15
Authors: Amr G Shafik; Hussam Adel Alkady; Gehad Mohamed Tawfik; Ahmed Mostafa Mohamed; Tahany Mohamed Rabie; Nguyen Tien Huy Journal: Braz J Otorhinolaryngol Date: 2019-10-03