The effects of upper airway surgery for obstructive sleep apnea on nasal continuous positive airway pressure settings.
OBJECTIVE
The objectives were to determine whether upper airway surgery lowers nasal continuous positive airway pressure (CPAP) settings for patients who require CPAP postoperatively for unresolved obstructive sleep apnea and to assess CPAP tolerability after upper airway surgery.


METHODS
Retrospective chart review.


METHODS
Patients who underwent upper airway surgery with preoperative and postoperative polysomnography at the University of Alabama at Birmingham (Birmingham, AL) between 1995 and 2000 were the focus of the study. Upper airway surgery was defined as uvulopalatopharyngoplasty alone or in addition to septoplasty and turbinoplasty. Recommended CPAP settings were recorded from preoperative and postoperative polysomnography studies to determine whether CPAP settings were decreased following surgery. A response to surgery was defined as a decrease of the recommended CPAP setting by at least 1 cm of water. A telephone interview was conducted to determine whether upper airway surgery improved CPAP comfort.


RESULTS
In 51.4% of the patients, CPAP settings were decreased following surgery. Continuous positive airway pressure settings were increased in 28.6% of patients and unchanged in 20%. Of the six patients who consistently used CPAP before and after surgery, four reported increased comfort postoperatively.


CONCLUSIONS
Upper airway surgery does not predictably reduce CPAP settings in the patient who requires postoperative CPAP for unresolved obstructive sleep apnea. Upper airway surgery may improve CPAP tolerability.
Masdon
James Lee
JL
Division of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, AL 35233, USA.
Magnuson
J Scott
JS
Youngblood
Garland
G
D000328:Adult; D000368:Aged; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010159:Palate / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D017286:Polysomnography; D019651:Plastic Surgery Procedures; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D014609:Uvula / Q000601:surgery