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European Archives of Oto-Rhino-Laryngology

, Volume 269, Issue 9, pp 2065–2067 | Cite as

The effects of CPAP treatment on nasal mucosa in patients with obstructive sleep apnea

  • Cem Saka
  • Erkan VuralkanEmail author
  • İbrahim Hikmet Fırat
  • Sibel Alicura
  • Sema Hücümenoğlu
  • İstemihan Akın
  • Sadık Ardıç
  • Ayhan Gökler
Rhinology

Abstract

The aim of the study was to demonstrate the effects of nasal CPAP treatment on the morphology and function of nasal mucosa in patients with obstructive sleep apnea (OSA). Patients with complaints relevant to OSA underwent respiratory function tests, arterial blood gas analyses and polysomnography. Saccharine test and nasal biopsies were performed to assess the mucociliary transport time and to observe the histopathological changes in patients with apnea–hypopnea index ≥15 in whole night polysomnography. Tissue samples were obtained from middle and inferior turbinates and septal mucosa to observe the degree of inflammation and fibrosis by semiquantitative means. Biopsies and mucociliary transport test were performed before and 3 months after the initiation of CPAP treatment. A total of 25 patients with a mean age of 52 were enrolled in the study. While the pretreatment mucociliary transport time before and 3 months after the treatment were 10.50 and 11.50 min respectively. The difference between these values was statistically insignificant. Mean apnea–hypopnea index was 63.19, while mean partial oxygen pressure was 75.46 mmHg. Nasal CPAP treatment was introduced with a mean pressure of 9.54 cmH2O. The degree of inflammation and fibrosis was found to be significantly increased after CPAP treatment. Nasal CPAP leads to alterations in mucosa. Efforts should be directed to make CPAP treatment a safer method via protecting the morphologic and functional properties of the nasal mucosa.

Keywords

Obstructive sleep apnea nCPAP Nasal Mucosa Mucociliary transport Fibrosis Inflammation 

Notes

Conflict of interest

There are no conflicts of interest related to this manuscript.

References

  1. 1.
    Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328:1230–1235PubMedCrossRefGoogle Scholar
  2. 2.
    Janjour N, Wilson P (1989) Pneumoencephalus associated with nasal CPAP in a patient with sleep apnoea. Chest 96:1452–1456Google Scholar
  3. 3.
    Strauffer J, Fayter N, MacLurg B (1984) Conjunctivitis from nasal CPAP apparatus (letter to editor). Chest 86:802CrossRefGoogle Scholar
  4. 4.
    Strumpf DA, Harrop P, Dobbin J, Millman R (1989) Massive epistaxis from nasal CPAP therapy. Chest 95:1141PubMedCrossRefGoogle Scholar
  5. 5.
    Sahin-Yilmaz A, Baroody FM, DeTineo M, Cuttance G, Makinson D, Pinto JM, Naureckas ET, Naclerio RM (2008) Effect of changing airway pressure on the ability of the human nose to warm and humidify air. Ann Otol Rhinol Laryngol 117:501–505PubMedGoogle Scholar
  6. 6.
    Lorenzi G, Böhm GM, Guimarães ET, Vaz MA, King M, Saldiva PH (1992) Correlation between rheologic properties and in vitro ciliary transport of rat nasal mucus. Biorheology 29:433–440PubMedGoogle Scholar
  7. 7.
    Papadopulas NG, Johnston SL (2001) Viral infection of the nose and the lung. ERS Monogr 18:79–100Google Scholar
  8. 8.
    Bossi R, Piatti G, Roma E, Ambrosseti U (2004) Effects of long-term nasal continuous positive airway pressure therapy on morphology, function, and mucociliary clearance of nasal epithelium in patients with obstructive sleep apnea syndrome. Laryngoscope 14:1431–1434CrossRefGoogle Scholar
  9. 9.
    de Oliviera LR, Yagi CSA, Figueiredo AC, Saldiva PHN, Lorenzi-Filho G (2006) Short-term effects of nCPAP on nasal mucociliary clearance and mucus transportability in healthy subjects. Respir Med 100:183–185CrossRefGoogle Scholar
  10. 10.
    Corbo MG, Foresi A, Bonfitto P, Mugnano A, Agabiti N, Cole PJ (1989) Measurement of nasal mucociliary clearance. Arch Dis Child 64:546–550PubMedCrossRefGoogle Scholar
  11. 11.
    Hilding A (1932) Experimental surgery of the nose and sinuses. Arch Otolaryngol 16:9–18CrossRefGoogle Scholar
  12. 12.
    Constantinidis J, Knöbber D, Steinhart H, Kuhn J, Iro H (2000) Fine-structural investigations of the effect of nCPAP-mask application on the nasal mucosa. Acta Otolaryngol 120:432–437PubMedCrossRefGoogle Scholar
  13. 13.
    Roessler F, Grossenbacher R, Walt H (1988) Die tracheobronchiale Schleimhautbeschaffenheit bei Patientenmit Langzeit-Tracheostoma. Eine rasterelektronenmikroskopische Studie. Laryngo Rhino Otol 67:66–71CrossRefGoogle Scholar
  14. 14.
    Schrodter S, Biermann E, Halata Z (2004) Histologic evaluation of nasal epithelium of the middle turbinate in untreated OSAS patients and during nCPAP therapy. Rhinology 42:153–157PubMedGoogle Scholar
  15. 15.
    Partinen M, Jamieson A, Guilleminault C (1988) Long-term outcome for obstructive sleep apnoea syndrome patients. Mortality Chest 94:1200–1204Google Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Cem Saka
    • 1
  • Erkan Vuralkan
    • 2
    • 5
    Email author
  • İbrahim Hikmet Fırat
    • 3
  • Sibel Alicura
    • 1
  • Sema Hücümenoğlu
    • 4
  • İstemihan Akın
    • 1
  • Sadık Ardıç
    • 3
  • Ayhan Gökler
    • 1
  1. 1.1st Department of ENTMinistry of Health Dışkapı Yıldırım Beyazıt Training and Research HospitalAnkaraTurkey
  2. 2.Department of ENTMinistry of Health Trabzon Numune Training and Research HospitalTrabzonTurkey
  3. 3.Department of Chest DiseasesMinistry of Health Dışkapı Yıldırım Beyazıt Training and Research HospitalAnkaraTurkey
  4. 4.2nd Department of PathologyMinistry of Health Dışkapı Yıldırım Beyazıt Training and Research HospitalAnkaraTurkey
  5. 5.Department of Otorhinolaryngology ClinicTrabzon Numune Training and Research HospitalTrabzonTurkey

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