title: Endoscopic dacryocystorhinostomy and obstructive sleep apnoea: the effects and outcomes of continuous positive airway pressure therapy.
abstract: BACKGROUND
  This study aims to assess the effects and outcomes of continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea (OSA) in patients who have undergone endoscopic dacryocystorhinostomy (DCR).
  
  
  METHODS
  Retrospective series in a university setting.
  
  
  METHODS
  A total of 205 consecutive patients were included in this study.
  
  
  METHODS
  A 10-year retrospective review was performed of 205 consecutive patients who had undergone powered endoscopic DCR for nasolacrimal duct obstruction. Patient notes were reviewed for demographic, clinical and surgical information. In addition, all patients were contacted and asked to complete a standardized telephone survey relating to OSA, CPAP use and associated symptoms.
  
  
  METHODS
  Effects of CPAP following DCR.
  
  
  RESULTS
  Ten of the 205 patients undergoing DCR were identified to use CPAP for obstructive sleep apnoea. Eight patients were initiated on a nasal device, while two used a full-face mask. The mean CPAP pressures were 8 cm H20 (range: 6-10 cm H20). Eighty percent (8/10) of patients complained of symptoms from the use of their CPAP following DCR. The most commonly described symptom was that of air regurgitation in 70% of patients followed by ophthalmic symptoms in 60% (6/10). 50% (5/10) of patients discontinued their CPAP as a consequence of their symptoms with 20% (2/10) discontinuing because of intolerable ophthalmic symptoms.
  
  
  CONCLUSIONS
  Symptoms from CPAP use post-endoscopic DCR are a common occurrence and may contribute to poor compliance with CPAP therapy. Detailed preoperative counseling with regards to CPAP use and its effects should be mandatory in known or at risk OSA patients undergoing DCR.
authors.affiliation: Dacryology Service, L.V. Prasad Eye Institute, Hyderabad, India.
authors.forename: Mohammad J
authors.initials: MJ
authors.lastname: Ali
authors.affiliation: Department of Surgery-Otolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Alkis J
authors.initials: AJ
authors.lastname: Psaltis
authors.affiliation: Department of Surgery-Otolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Jae
authors.initials: J
authors.lastname: Murphy
authors.affiliation: Department of Surgery-Otolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Peter John
authors.initials: PJ
authors.lastname: Wormald
mesh_terms: D000368:Aged; D045422:Continuous Positive Airway Pressure; D003608:Dacryocystorhinostomy; D004724:Endoscopy; D005260:Female; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery; D015995:Prevalence; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000628:therapy*
keywords: CPAP; air regurgitation; endoscopic DCR; sleep apnea