title: Same-stage nasal and palatopharyngeal surgery for obstructive sleep apnea: is it safe?
abstract: OBJECTIVE
  The study goal was to determine the safety of performing same-stage nasal and palatopharyngeal surgery for the treatment of obstructive sleep apnea syndrome (OSAS).
  
  
  METHODS
  We conducted a retrospective review of 91 consecutive patients who underwent surgery for OSAS at tertiary care facilities.
  
  
  METHODS
  Patients were divided into 2 groups: group 1 had same-stage nasal and palatopharyngeal surgery (n = 63), whereas group 2 had palatopharyngeal surgery at a stage separate from the nasal surgery (n = 28). Patient demographics, severity of OSAS, type of surgery, perioperative care, and postoperative complications were reviewed.
  
  
  RESULTS
  There were 55 men and 8 women in group 1, with an average age of 48 years. Group 2 consisted of 20 men and 8 women, with an average age of 45 years. The mean respiratory disturbance index was 36.5 and 33.5 for group 1 and 2, respectively. The mean lowest arterial Oxygen saturation for group 1 was 82%, whereas that of group 2 was 81%. Patients in both groups were observed in a hospital setting for a minimum of 1 day. They were admitted to a room close to the nurse's station, with continuous pulse oximeter monitoring. There were 3 complications reported for group 1: pneumonia (1 patient, postoperative day 4), tonsil bleed (1 patient, postoperative day 6), and septal hematoma (1 patient). One patient in group 2 had a tonsil bleed (postoperative day 8). There were no incidents of airway compromise or cardiopulmonary events in the immediate postoperative period.
  
  
  CONCLUSIONS
  Same-stage nasal and palatopharyngeal surgery for OSAS is safe. Patients could be monitored with continuous pulse oximetry and managed outside of an intensive care unit setting in the immediate postoperative period.
authors: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Division of Otolaryngology, Boston VA Healthcare System, and Department of Otology and Laryngology, Harvard Medical School, 02114, USA. nicolas_busaba@meei.harvard.edu
authors: Nicolas Y
authors: NY
authors: Busaba
mesh_terms: D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009666:Nose / Q000601:surgery*; D010092:Oximetry; D010159:Palate / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D014609:Uvula / Q000601:surgery