The effect of nasal surgery on nasal continuous positive airway pressure compliance. 2014

Justin Poirier, and Charles George, and Brian Rotenberg
Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

OBJECTIVE Nasal continuous positive airway pressure (CPAP) is the standard therapy for sleep apnea; however, compliance rates are historically poor. Among the most commonly cited reasons for nonadherence is nasal obstruction. Our study sought to examine if nasal surgery actually increases CPAP compliance. METHODS Prospective case series. METHODS Nasal CPAP-intolerant obstructive sleep apnea (OSA) patients, with documented nasal obstruction, underwent septoplasty plus inferior turbinoplasty. Preoperative and postoperative data were collected on CPAP usage per night and subjective nasal obstruction with the Nasal Obstruction Symptom Evaluation (NOSE) Scale questionnaire. RESULTS Eighteen patients met inclusion criteria and underwent septoplasty. CPAP usage increased significantly from 0.5 hours per night preoperatively to 5 hours per night postoperatively (P < .05). Subjective nasal obstruction on the NOSE Scale decreased from 16.1 preoperatively to 5.4 following surgical intervention (P < .05). CPAP pressure decreased from 11.9 preoperatively to 9.2 after surgery, with a trend toward significance (P = .062). CONCLUSIONS This study demonstrates improved CPAP compliance rates following septoplasty in OSA patients with nasal obstruction. Correction of nasal obstruction should be offered in nasal CPAP-intolerant individuals to improve CPAP compliance.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010349 Patient Compliance Voluntary cooperation of the patient in following a prescribed regimen. Client Adherence,Client Compliance,Non-Adherent Patient,Patient Adherence,Patient Cooperation,Patient Noncompliance,Patient Non-Adherence,Patient Non-Compliance,Patient Nonadherence,Therapeutic Compliance,Treatment Compliance,Adherence, Client,Adherence, Patient,Client Compliances,Compliance, Client,Compliance, Patient,Compliance, Therapeutic,Compliance, Treatment,Cooperation, Patient,Non Adherent Patient,Non-Adherence, Patient,Non-Adherent Patients,Non-Compliance, Patient,Nonadherence, Patient,Noncompliance, Patient,Patient Non Adherence,Patient Non Compliance,Patient, Non-Adherent,Therapeutic Compliances,Treatment Compliances
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015508 Nasal Obstruction Any hindrance to the passage of air into and out of the nose. The obstruction may be unilateral or bilateral, and may involve any part of the NASAL CAVITY. Bilateral Nasal Obstruction,Nasal Airway Obstruction,Nasal Blockage,Unilateral Nasal Obstruction,Airway Obstruction, Nasal,Blockage, Nasal,Blockages, Nasal,Nasal Blockages,Nasal Obstruction, Bilateral,Nasal Obstruction, Unilateral,Obstruction, Bilateral Nasal,Obstruction, Nasal,Obstruction, Nasal Airway,Obstructions, Nasal
D045422 Continuous Positive Airway Pressure A technique of respiratory therapy, in either spontaneously breathing or mechanically ventilated patients, in which airway pressure is maintained above atmospheric pressure throughout the respiratory cycle by pressurization of the ventilatory circuit. (On-Line Medical Dictionary [Internet]. Newcastle upon Tyne(UK): The University Dept. of Medical Oncology: The CancerWEB Project; c1997-2003 [cited 2003 Apr 17]. Available from: http://cancerweb.ncl.ac.uk/omd/) Airway Pressure Release Ventilation,BiPAP Bilevel Positive Airway Pressure,BiPAP Biphasic Positive Airway Pressure,Bilevel Positive Airway Pressure,Biphasic Positive Airway Pressure,APRV Ventilation Mode,Bilevel Continuous Positive Airway Pressure,Biphasic Continuous Positive Airway Pressure,CPAP Ventilation,Nasal Continuous Positive Airway Pressure,nCPAP Ventilation,APRV Ventilation Modes,Ventilation Mode, APRV,Ventilation Modes, APRV,Ventilation, CPAP,Ventilation, nCPAP
D059747 Nasal Surgical Procedures Surgical operations on the nose and nasal cavity. Intranasal Surgery,Nasal Surgery,Rhinosurgery,Intranasal Surgeries,Nasal Surgeries,Nasal Surgical Procedure,Procedure, Nasal Surgical,Procedures, Nasal Surgical,Rhinosurgeries,Surgeries, Intranasal,Surgeries, Nasal,Surgery, Intranasal,Surgery, Nasal,Surgical Procedure, Nasal,Surgical Procedures, Nasal
D020181 Sleep Apnea, Obstructive A disorder characterized by recurrent apneas during sleep despite persistent respiratory efforts. It is due to upper airway obstruction. The respiratory pauses may induce HYPERCAPNIA or HYPOXIA. Cardiac arrhythmias and elevation of systemic and pulmonary arterial pressures may occur. Frequent partial arousals occur throughout sleep, resulting in relative SLEEP DEPRIVATION and daytime tiredness. Associated conditions include OBESITY; ACROMEGALY; MYXEDEMA; micrognathia; MYOTONIC DYSTROPHY; adenotonsilar dystrophy; and NEUROMUSCULAR DISEASES. (From Adams et al., Principles of Neurology, 6th ed, p395) Obstructive Sleep Apnea,Upper Airway Resistance Sleep Apnea Syndrome,Apnea, Obstructive Sleep,OSAHS,Obstructive Sleep Apnea Syndrome,Sleep Apnea Hypopnea Syndrome,Sleep Apnea Syndrome, Obstructive,Syndrome, Obstructive Sleep Apnea,Syndrome, Sleep Apnea, Obstructive,Syndrome, Upper Airway Resistance, Sleep Apnea,Apneas, Obstructive Sleep,Obstructive Sleep Apneas,Sleep Apneas, Obstructive

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