Management of patients with severe obstructive sleep apnea following rhinosurgical interventions. A pilot study

Background. Patients with severe obstructive sleep apnea (OSA) treated by n asal continuous positive airway pressure (CPAP) often undergo rhinosurgery to improve nasal ventilation and comply with CPAP therapy. The use of nasal packing postoperatively may worsen the severity of their sleep-related bre athing disorders, even leading to death. For this reason, postoperative sur veillance with CPAP ventilation is recommended. An oral connection piece of fers the possibility to continue CPAP therapy. Patients and method. Five patients with OSA were enrolled in this pilot stu dy. All patients underwent a septorhinoplasty with nasal packing for 2 days . CPAP ventilation was guaranteed postoperatively by using an oral connecti on piece. The object of the study was to evaluate the feasibility, effectiv eness, and acceptance of CPAP ventilation with this oral connection piece i n patients with nasal packing. Therefore, the blood oxygenation of the pati ents was observed by pulse oximetry pre- and postoperatively. Results. None of the patients with nasal packing showed apneas or hypopneas with arterial blood oxygen saturation below 92%. Application of oxygen was not necessary. Cardiorespiratory or neurological complications were not ob served. Conclusion. The oral connection piece offers a feasible and effective oppor tunity to continue CPAP ventilation therapy after rhinosurgery in patients with OSA. The acceptance of the method is satisfactory.