title: The Prevalence of Air Regurgitation and Its Consequences After Conjunctivodacryocystorhinostomy and Dacryocystorhinostomy in Continuous Positive Airway Pressure Patients.
abstract: OBJECTIVE
  To describe the prevalence of air regurgitation into the periocular region in continuous positive airway pressure (CPAP) patients with a history of conjunctivodacryocystorhinostomy with a Lester Jones tube and a dacryocystorhinostomy with silicone intubation, as well as problems caused by this regurgitation and methods to cope.
  
  
  METHODS
  A retrospective chart review of patients who either underwent a conjunctivodacryocystorhinostomy or dacryocystorhinostomy was performed. Patients were contacted via phone interview. Demographic information, history of sleep apnea, use of CPAP, and presence of air regurgitation and associated complications were recorded. Institutional review board/ethics committee approval was obtained.
  
  
  RESULTS
  Two patients who underwent a conjunctivodacryocystorhinostomy with Lester Jones tube and were on CPAP were identified. Both complained of air regurgitation, sensation of Lester Jones tube moving due to regurgitation, and periodic eye pain. Twenty-two patients who underwent a dacryocystorhinostomy with silicone stent and used CPAP were identified. Of these, 16 (72.7%) complained of air regurgitation. Difficulty sleeping (56.2%), dry eye symptoms upon waking (68.8%), eye pain upon waking (31.3%), and blurry vision upon waking (12.5%) were the commonest complaints due to air regurgitation. A total of 7 (43.7%) patients had to discontinue their CPAP at some point due to symptoms.
  
  
  CONCLUSIONS
  This study brings to light the prevalence of air regurgitation in dacryocystorhinostomy procedures, and its associated symptoms. Given that this procedure is much more common than conjunctivodacryocystorhinostomy, surgeons should consider asking patients before performing surgery whether they use CPAP. Patients should be consented regarding the risk of air regurgitation and associated dry eye, foreign body sensation, and eye pain.
authors.affiliation: *Department of Ophthalmology, University of Alabama at Birmingham; †Alabama Ophthalmology Associates; and ‡University of Alabama School of Medicine, Birmingham, Alabama, U.S.A.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Vicinanzo
authors.forename: Chaitanya
authors.initials: C
authors.lastname: Allamneni
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Compton
authors.forename: John A
authors.initials: JA
authors.lastname: Long
authors.forename: Cameron B
authors.initials: CB
authors.lastname: Nabavi
mesh_terms: D000328:Adult; D000368:Aged; D000388:Air; D003228:Conjunctiva / Q000601:surgery; D045422:Continuous Positive Airway Pressure; D003608:Dacryocystorhinostomy / Q000009:adverse effects* / Q000295:instrumentation; D004646:Emphysema / Q000453:epidemiology / Q000209:etiology*; D005128:Eye Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007440:Intubation; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D015607:Stents