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Abstract Nasal obstruction is a common complaint in patients with sleep disordered breathing, occurring in up to 45% of patients. Nasal airway resistance is responsible for approximately two-thirds of total airway resistance. Common nasal surgeries performed to improve nasal breathing and for sleep-disordered breathing include septoplasty, turbinate reduction, and nasal valve reconstruction. Septoplasty involves straightening of the nasal septum. The procedure may be done under local or general anesthesia and a variety of techniques are used based on surgical training, type, and position of the septal deviation. Reducing a few millimeters of anterior septal deviation has been shown to produce significant improvements in nasal airway resistance. The aim of this study was to evaluate the outcomes of traditional septoplasty with or without inferior turbinate reduction in patients suffering from obstructive sleep apnea due to nasal cause. In this observational comparative study, the intranasal surgery has a good effect on the subjective quality of sleep in OSA patients, and that there might be an added effect on AHI in selected patients with both septal deviation and hypertrophy of the inferior turbinates. A total of 60 patients enrolled in this study, their ages ranged from 18 to 52 years old. In both groups, there was a predominance of males (57% in-group A and 70 % in-group B). Females represent (43% in-group A and 30% in-group B). The groups did not differ significantly regarding preoperative AHI, ODI, ESS, Mallampati score, age, gender or BMI. We looked at changes in the objective parameters before and after surgery in three ways: the overall changes in both groups pooled together, changes within each group, and the changes in the mean difference between the groups. Overall, in both groups together, there was a significant reduction in mean AHI after surgery. In comparison, when we looked at each group separately, we found a significant reduction in-group A in mean AHI. In group B there was no significant reduction in mean AHI, ODI or BMI after surgery, but there was a significant reduction in the mean ESS score. According to the degree of postoperative changes in the number of apneas hypopneas per hour of sleep (AHI), patients were divided into responders and non-responders. Patients who showed 50% or more reduction in their AHI were considered responders, while patients who did not reached this level of reduction were considered non- responders. Cure was defined as reduction of pre-operative AHI by 50% or more.[91] In group A: there was 10 patients responders represent 33.3% and 20 patients non-responders represent 66.7% . In group B: there was six patients responders represent 20% and 24 patients nonresponders represent 80% |