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

Authors

  • Justin Poirier MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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  • Charles George MD, FRCPC,

    1. Division of Respirology and Sleep Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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  • Brian Rotenberg MD, MPH

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
    • Send correspondence to Brian Rotenberg, MD, St. Joseph's Healthcare Centre, 268 Grosvenor St., London, Ontario, Canada N6A 4V2. E-mail: brian.rotenberg@sjhc.london.on.ca

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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis

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.

Study Design

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 signifiance (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.

Level of Evidence

3b Laryngoscope, 124:317–319, 2014

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