Impact of Obstructive Sleep Apnea on Outcomes of Minimally Invasive Nasal Surgery for Chronic Rhinitis

Importance Chronic rhinitis (CR) affects quality of life and often coexists with obstructive sleep apnea (OSA), a comorbidity that may increase surgical risks. Understanding OSA’s impact on outcomes of minimally invasive nasal surgery is clinically relevant. Objective To evaluate the efficacy and safety of minimally invasive nasal surgery for CR and assess the influence of OSA on postoperative complications and symptom relief. Design Retrospective cohort study. Setting Single tertiary medical center in Taiwan. Participants A total of 325 CR patients underwent nasal surgery between March 2023 and June 2024. Based on sleep study results, patients were stratified into OSA (n = 48) and non-OSA (n = 277) groups. Exposure or Intervention Minimally invasive nasal surgery, including radiofrequency inferior turbinate reduction and/or posterior nasal nerve neurolysis. Patients receiving adjunctive procedures (eg, septoplasty, uvulopalatopharyngoplasty, and tonsillectomy) were excluded. Main Outcome Measures Postoperative complications (eg, epistaxis) within 1 month and symptom relief based on reflective total nasal symptom score and nasal obstruction symptom evaluation. Results OSA [odds ratio (OR), 5.105; 95% confidence interval (CI), 1.222-21.328; P = .025] and hypertension (OR, 5.809; 95% CI, 1.134-29.744; P = .035) were independent risk factors for major epistaxis. OSA patients had higher overall complication rates (22.9% vs 4.3%, P = .005), epistaxis (18.8% vs 3.6%, P = .012), and major epistaxis (14.6% vs 1.8%, P = .018). Both groups showed significant symptom improvement postoperatively ( P < .001). Conclusion Minimally invasive nasal surgery improves CR symptoms regardless of OSA. However, OSA and hypertension are linked to increased complication risk and require careful perioperative management. Relevance These findings support tailored preoperative assessment and multidisciplinary care to optimize safety and outcomes in CR patients with OSA.