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Upper airway surgery: the effect on nasal continuous positive airway pressure titration on obstructive sleep apnea patients

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Abstract

The objective of this study was to observe the change in CPAP pressure after nasal and/or tonsil surgery in a retrospective study involving 17 patients unable to tolerate CPAP titration. All patients had two polysomnography studies for titration: one before and another subsequent to upper airway surgical treatment. The results showed a mean age of 49±9 years, a body mass index of 30±4 kg/m2 and an apnea-hypopnea index of 38±19. Surgical procedures were radiofrequency reduction of the inferior turbinate (eight patients), septoplasty (one patient), septoplasty with inferior turbinectomy (two patients), septoplasty with inferior turbinate submucosal diathermy (two patients), septoplasty with tonsillectomy (two patients), septoplasty with inferior turbinate submucosal diathermy and tonsillectomy (one patient) and tonsillectomy (one patient). CPAP titration before and after surgery had respectively a mean pressure of 12.4±2.5 and 10.2±2.2 cmH2O ( P =0.001). Maximum CPAP pressure was 16.4 cmH2O before and 13 cmH2O after surgery. A pressure reduction ≥1 cmH2O occurred in 76.5% of the patients and ≥3 cmH2O in 41.1%. Upper airway surgical treatment appears to have some benefit by reducing nasal CPAP pressure levels. The effect seems to be greater when the prior pressure was ≥14 cmH2O.

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Acknowledgments

The authors would like to thank to Terri E. Weaver, PhD, RN, CS, FAAN, for her valuable support.

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Correspondence to Adriane Iurck Zonato.

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This investigation was conducted at the Sleep Center of the Psychobiology Department and at the Otorhinolaryngology Department, Universidade Federal de São Paulo, São Paulo-SP, Brazil. The authors disclose that they were not the recipients of any form of financial support, nor did they have any involvement with organization(s) with financial interest in the subject matter. This paper was presented in the 17th Annual APSS Meeting, Chicago, IL, 3–8 June 2003.

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Zonato, A.I., Bittencourt, L.R.A., Martinho, F.L. et al. Upper airway surgery: the effect on nasal continuous positive airway pressure titration on obstructive sleep apnea patients. Eur Arch Otorhinolaryngol 263, 481–486 (2006). https://doi.org/10.1007/s00405-005-1018-y

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