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Huang X, Gan Y, Xia X, Gu T, Peng S, Wu J, Chen X, Liang Y, Guo Z, Lin J. Submucosal Trans-Septal Suturing Technique After a Septal Extension Graft with Porous High-Density Polyethylene: A Technical Report. Aesthetic Plast Surg 2024:10.1007/s00266-024-04052-8. [PMID: 38831066 DOI: 10.1007/s00266-024-04052-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/09/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Porous high-density polyethylene (pHDPE) is an alternative material for a septal extension graft (SEG) in oriental rhinoplasty when autologous cartilage is limited. Although nasal packing (NP) and trans-septal suturing (TSS) techniques are routine procedures to obviate the dead space after septoplasty, they are associated with certain discomforts and complications. OBJECTIVE To investigate the application of a submucosal trans-septal suturing (STSS) technique after SEG with pHDPE. METHODS A prospective study was conducted on 60 female participants who underwent SEG with pHDPE. The participants were randomly divided into the NP group and STSS group. The extra surgical duration of NP and STSS, pain, nasal obstruction, and sleeping disturbance as well as postoperative complications were recorded and compared between groups. RESULTS No significant difference was found between group NP and group STSS in terms of mean age. The mean extra surgical duration of group STSS was significantly longer than group NP. There were significant higher pains of group NP at 24 hours and 48 hours postoperatively, compared with group STSS. The NP group also experienced significantly more nasal obstruction and sleep disturbance within 48h postoperatively compared to the STSS group. There was one infection in each group, minor bleeding in two NP patients, and one STSS patient. There was no major bleeding, hematoma, graft exposure, or septal perforation in both groups. CONCLUSION Although STSS needs a longer extra surgical duration than NP, it significantly improves the patient's postoperative comfort with a faster return to normal respiration compared to NP. LEVEL OF EVIDENCE I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Xin Huang
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Yufeng Gan
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Xiaofeng Xia
- Department of Plastic Surgery, Hangzhou Fuyang Hospital of Traditional Chinese Medicine, No.4 Guihua Road, Hangzhou, 311400, Zhejiang, China
| | - Tianya Gu
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Su Peng
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Jie Wu
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Xiang Chen
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Yan Liang
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Zongke Guo
- Department of Plastic Surgery, Zhongda Hospital, Southeast University, No.87 Dingjiaqiao, Nanjing, Jiangsu, China.
| | - Jinde Lin
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China.
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Mettias B, Karia CT, Irvine E, Conboy P. Comparison of side effects and patient perceptions towards Rapid Rhino and Merocel packs in epistaxis. J Laryngol Otol 2024; 138:642-646. [PMID: 38230503 DOI: 10.1017/s0022215124000094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
OBJECTIVE Non-dissolvable nasal packs (Rapid Rhino and Merocel) are widely used in secondary healthcare centres for the control of epistaxis, with some side effects. METHODS A prospective, observational cohort study was conducted of adults who required Rapid Rhino or Merocel packing for acute epistaxis management in a large healthcare centre between March 2020 and 2021. A validated modified version of the 22-item Sino-Nasal Outcome Test was used. RESULTS A total of 80 adults requiring non-dissolvable packs were recruited. Seventy per cent of patients had Rapid Rhino packs inserted. Embarrassment was greater in patients who used Rapid Rhino than Merocel. Merocel packs had a significantly higher mean pain score on removal compared to Rapid Rhino. There was no correlation between rebleed rate and type of nasal pack used. CONCLUSION Non-dissolvable Rapid Rhino and Merocel nasal packs have similar efficacy in controlling epistaxis. Rapid Rhino packs are more embarrassing for patients in comparison to Merocel packs, but are less painful to remove.
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Affiliation(s)
- Bassem Mettias
- Department of Otorhinolaryngology, University Hospitals of Leicester, Leicester, UK
| | | | - Esmee Irvine
- Department of Otorhinolaryngology, University Hospitals of Leicester, Leicester, UK
| | - Peter Conboy
- Department of Otorhinolaryngology, University Hospitals of Leicester, Leicester, UK
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Wakasugi R, Sasaki T, Takano S, Kamada H, Yoshioka K, Tochigi K, Ikeda R, Takahashi N, Matsuyama H, Horii A. Plus moist HS-W ®: a new nasal packing material for the middle meatus in endoscopic sinus surgery. Eur Arch Otorhinolaryngol 2024; 281:2985-2991. [PMID: 38219246 PMCID: PMC11065909 DOI: 10.1007/s00405-023-08437-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 12/22/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE Removal of the current calcium alginate packing materials to the middle meatus in endoscopic sinus surgery (ESS) is usually accompanied by discomfort or pain owing to the hard and brittle nature of these materials. Plus moist HS-W® is a new calcium alginate packing material released in 2022 developed to overcome this issue by changing the uronic acid component. We aimed to compare the discomfort/pain during the removal of Plus moist HS-W® with Kaltostat®, as well as their suitability as packing materials in ESS. METHODS Kaltostat® and Plus moist HS-W® were used as packing materials in 22 and 21 patients who underwent ESS in 2021 and 2022, respectively. Patients were asked to rate the pain during the packing removal 10 days after ESS using the Numerical Rating Scale (NRS). The ratio of residual packing materials, number of suctions (insertions/extractions of the suction cannula), and time required to remove packing materials were measured. Postoperative complications such as hemorrhage, local infection, lateralization of the middle turbinate, and synechia of the middle meatus were also evaluated. RESULTS The Plus moist HS-W® group exhibited significantly lower NRS pain scores, a lower ratio of residual packing materials, a reduced number of suctions, and a shorter time required to remove the packing. No obvious postoperative complications occurred in both groups except for one suspicious case of a slight infection in the Kaltostat® group. CONCLUSION Compared with Kaltostat®, Plus moist HS-W®, characterized by better gelatinization than Kaltostat®, benefits patients by minimizing discomfort/pain during removal. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- Ryo Wakasugi
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan.
| | - Takanobu Sasaki
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan
| | - Satoshi Takano
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan
| | - Hisashi Kamada
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan
| | - Kuniaki Yoshioka
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan
| | - Kaori Tochigi
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan
| | - Ryo Ikeda
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan
| | - Nao Takahashi
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan
| | - Hiroshi Matsuyama
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan
| | - Arata Horii
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan
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Suo L, Lu L, Li J, Qiu L, Liu J, Shi J, Sun Z, Lao W, Zhou X. The effect of deep and awake extubation on emergence agitation after nasal surgery: a randomized controlled trial. BMC Anesthesiol 2024; 24:177. [PMID: 38762729 PMCID: PMC11102170 DOI: 10.1186/s12871-024-02565-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 05/14/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND Post-anesthetic emergence agitation is common after general anesthesia and may cause adverse consequences, such as injury as well as respiratory and circulatory complications. Emergence agitation after general anesthesia occurs more frequently in nasal surgery than in other surgical procedures. This study aimed to assess the occurrence of emergence agitation in patients undergoing nasal surgery who were extubated under deep anesthesia or when fully awake. METHODS A total of 202 patients (18-60 years, American Society of Anesthesiologists classification: I-II) undergoing nasal surgery under general anesthesia were randomized 1:1 into two groups: a deep extubation group (group D) and an awake extubation group (group A). The primary outcome was the incidence of emergence agitation. The secondary outcomes included number of emergence agitations, sedation score, vital signs, and incidence of adverse events. RESULTS The incidence of emergence agitation was lower in group D than in group A (34.7% vs. 72.8%; p < 0.001). Compared to group A, patients in group D had lower Richmond Agitation-Sedation Scale scores, higher Ramsay sedation scores, fewer agitation episodes, and lower mean arterial pressure when extubated and 30 min after surgery, whereas these indicators did not differ 90 min after surgery. There was no difference in the incidence of adverse events between the two groups. CONCLUSIONS Extubation under deep anesthesia can significantly reduce emergence agitation after nasal surgery under general anesthesia without increasing the incidence of adverse events. TRIAL REGISTRATION Registered in Clinicaltrials.gov (NCT04844333) on 14/04/2021.
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Affiliation(s)
- Lulu Suo
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China
| | - Lu Lu
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China
| | - Jingjie Li
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China
| | - Lin Qiu
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China
| | - Jinxing Liu
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China
| | - Jinya Shi
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China
| | - Zhujie Sun
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China
| | - Wei Lao
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China.
| | - Xuhui Zhou
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China.
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Weber RK, Sommer F, Heppt W, Hosemann W, Kühnel T, Beule AG, Laudien M, Hoffmann TK, Hoffmann AS, Baumann I, Deitmer T, Löhler J, Hildenbrand T. [Fundamentals and practice of the application of nasal packing in sinonasal surgery]. HNO 2024; 72:3-15. [PMID: 37845539 DOI: 10.1007/s00106-023-01369-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND AND OBJECTIVES This paper presents an overview on nasal packing materials which are available in Germany. The current literature is analyzed whether there are robust criteria regarding use nasal packing after sinonasal surgery, whether there are fundamental and proven advantages or disadvantages of products, and what this means in clinical practice. MATERIALS AND METHODS Selective literature analysis using the PubMed database (key words "nasal packing", "nasal tamponade", "nasal surgery", "sinonasal surgery", or "sinus surgery"), corresponding text books and resulting secondary literature. RESULTS AND CONCLUSIONS Because of systematic methodological shortcomings, the literature does not help in the decision-making about which nasal packing should be used after which kind of sinonasal surgery. In fact, individual approaches for the many different clinical scenarios are recommended. In principle, nasal packing aims in hemostasis, should promote wound healing, and should not result in secondary morbidity. Nasal packing materials should be smooth (non-absorbable materials), inert (absorbable materials), and should not exert excessive pressure. Using non-absorbable packing entails the risk of potentially lethal aspiration and ingestion. For safety reasons inpatient control is recommended as long as this packing is in situ. With other, uncritical packing materials and in patients with special conditions, outpatient control could be justified.
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Affiliation(s)
- Rainer K Weber
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Städtisches Klinikum Karlsruhe, Karlsruhe, Deutschland.
- Sinus Academy, Karlsruhe, Deutschland.
- Sektion Nasennebenhöhlen- und Schädelbasischirurgie, Traumatologie, HNO-Klinik, Städtisches Klinikum Karlsruhe, Moltkestr. 90, 76133, Karlsruhe, Deutschland.
| | - Fabian Sommer
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - Werner Heppt
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Städtisches Klinikum Karlsruhe, Karlsruhe, Deutschland
| | - Werner Hosemann
- Klinik für Hals-Nasen-Ohrenheilkunde, Heliosklinikum Stralsund, Stralsund, Deutschland
| | - Thomas Kühnel
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Achim Georg Beule
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Münster, Münster, Deutschland
- Deutsches Zentrum für Erkrankungen der oberen Atemwege, Münster, Deutschland
| | - Martin Laudien
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Kiel, Kiel, Deutschland
| | - Thomas K Hoffmann
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - Anna Sophie Hoffmann
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg-Eppendorf, Deutschland
| | - Ingo Baumann
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Thomas Deitmer
- Deutsche Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie e. V., Bonn, Deutschland
| | - Jan Löhler
- Deutscher Berufsverband der HNO-Ärzte e. V., Neumünster, Deutschland
| | - Tanja Hildenbrand
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Freiburg, Deutschland
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Gilman R, Ganesh Kumar N. Invited Discussion on: Comparison of the Ankaferd Blood Stopper Tampon and the Merocel Nasal Tampon after Septoplasty Surgery. Aesthetic Plast Surg 2023; 47:301-303. [PMID: 36018328 DOI: 10.1007/s00266-022-03073-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/13/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Robert Gilman
- Section of Plastic Surgery, Department of Surgery, University of Michigan, 1500 E. Medical Center Drive, 2130 Taubman Center, Ann Arbor, MI, 48109, USA.
| | - Nishant Ganesh Kumar
- Section of Plastic Surgery, Department of Surgery, University of Michigan, 1500 E. Medical Center Drive, 2130 Taubman Center, Ann Arbor, MI, 48109, USA
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Guan S, Zhao T, Ye J, Zhang J. Influence of bilateral nasal packing on sleep oxygen saturation after general anesthesia: A prospective cohort study. Front Surg 2023; 10:1083961. [PMID: 36793309 PMCID: PMC9922837 DOI: 10.3389/fsurg.2023.1083961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/02/2023] [Indexed: 01/31/2023] Open
Abstract
Objective This study aims to evaluate the effect of bilateral nasal packing on sleep oxygen saturation and its influencing factors on the first night after general anesthesia. Method A total of 36 adult patients who underwent bilateral nasal packing with a nonabsorbable expanding sponge after general anesthesia surgery were prospectively studied. All these patients underwent overnight oximetry tests before and the first night after surgery. The following oximetry variables were collected for analysis: the lowest oxygen saturation (LSAT), the average oxygen saturation (ASAT), the oxygen desaturation index of ≥4% (ODI4), and the percentage of time with oxygen saturation below 90% (CT90). Results Among the 36 patients, the incidences of both sleep hypoxemia and moderate-to-severe sleep hypoxemia increased with bilateral nasal packing after general anesthesia surgery. All the pulse oximetry variables we studied deteriorated significantly after surgery: both LSAT and ASAT decreased significantly (P < 0.05), while both ODI4 and CT90 increased significantly (P < 0.05). In a multiple logistic regression analysis, body mass index (BMI), LSAT, and modified Mallampati grade were found to be independently predictive for a larger decrease in LSAT (≥5%) after surgery (all P's < 0.05). Conclusion Bilateral nasal packing after general anesthesia could induce or aggravate sleep hypoxemia, especially in patients with obesity, relatively normal sleep oxygen saturation, and high modified Mallampati grades.
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Affiliation(s)
- Shuwen Guan
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, China,Department of Otorhinolaryngology, Head and Neck Surgery, Shenzhen University General Hospital, Shenzhen, China
| | - Tingting Zhao
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Jingying Ye
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China,Correspondence: Junbo Zhang Jingying Ye
| | - Junbo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, China,Department of Otolaryngology, Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China,Correspondence: Junbo Zhang Jingying Ye
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Outcome of Continuous Positive Airway Pressure Adherence Based on Nasal Endoscopy and the Measurement of Nasal Patency-A Prospective Study. LIFE (BASEL, SWITZERLAND) 2023; 13:life13010219. [PMID: 36676168 PMCID: PMC9867109 DOI: 10.3390/life13010219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
The gold standard for treating obstructive sleep apnea in adults is continuous positive airway pressure (CPAP). However, it can be difficult to convince patients to adhere to this therapy. The aim of this study was to determine the relationship between nasal endoscopy findings/nose patency and CPAP adherence. Material and methods: A cohort of 450 consecutive patients suspected of having OSA were prospectively enrolled. For further analyses, 47 OSA patients undergoing CPAP treatment were selected (13 females and 34 males, average age, 65.3 years, BMI 34.1, apnea-hypopnea index. AHI 51.0). The patients were divided into two groups: patients with good CPAP adherence (n = 35) and patients who did not adhere to CPAP therapy (n = 12). The influence of nasal endoscopy and flow measurement on CPAP adherence was explored. Results: We found a statistical independence between adherence to CPAP and AHI (p = 0.124), T90 (p = 0.502), endoscopic findings (p = 0.588) and nasal patency measured by a flowmeter (p = 0.498). Conclusions: In our studied sample, endoscopic findings and nasal patency measured by a flowmeter were not predictors of CPAP non-adherence in the first year of the treatment. Our data show that while an endoscopic finding in the nasal cavity could indicate that a patient has a severe obstruction, compliance with CPAP therapy is not reduced in these patients and neither is it reduced with a decrease in nasal flow, according to our observation.
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