History, Clinical Examination, and Diagnosis of Snoring and Obstructive Sleep Apnea–Hypopnea Syndrome

Deenadayal, D. S.; Bommakanti, Vyshanavi

doi:10.1007/978-981-16-6620-9_6

Cited by 1 publication

(3 citation statements)

References 19 publications

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“…A score of greater than 5 indicates a high risk of OSA. 8 Other screening tools for OSA include Epworth Sleepiness Scale (ESS), Stanford questionnaire, and Berlin questionnaire 10 . In those patients with high risk of OSA, consideration should be given to perform polysomnography prior to surgical intervention to fully understand their risk of surgical intervention.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…This identifies anatomical areas of collapse in the upper airway that could be contributing to a patient's OSA. DISE is typically done in an office with procedural capabilities or an ambulatory surgical setting as it requires intravenous sedation 10 . In an OSA patient with CPAP intolerance, consideration This article is protected by copyright.…”

Section: Drug Induced Sleep Endoscopymentioning

confidence: 99%

“…DISE is typically done in an office with procedural capabilities or an ambulatory surgical setting as it requires intravenous sedation. 10 In an OSA patient with CPAP intolerance, consideration should be made to offer further workup regarding CPAP alternative options. If the surgeon performing nasal surgery does not offer DISE as part of their practice, they should consider collaboration with a provider with familiarity in this technique.…”

Section: Drug-induced Sleep Endoscopymentioning

confidence: 99%

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Considerations for Functional Nasal Surgery in the Obstructive Sleep Apnea Population

Coviello

Sivam

2023

Facial Plast Surg

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Obstructive sleep apnea (OSA) and nasal obstruction are common in the general population and frequently treated by otolaryngologists and facial plastic surgeons. Understanding the appropriate pre-, peri-, and postoperative management of OSA patients undergoing functional nasal surgery is important. OSA patients should be appropriately counseled in the preoperative period on their increased anesthetic risk. In OSA patients who are continuous positive airway pressure (CPAP) intolerant, the role of drug induced sleep endoscopy (DISE) should be discussed with the patient and depending on the surgeon’s practice may prompt referral to a sleep specialist. Should multilevel airway surgery be indicated, it can safely be performed in most OSA patients. Surgeons should communicate with the anesthesiologist regarding an airway plan given this patient population’s higher propensity for having a difficult airway. Given their increased risk of postoperative respiratory depression, extended recovery time should be given to these patients and the use of opioids as well as sedatives should be minimized. During surgery, one can consider using local nerve blocks to reduce postoperative pain and analgesic use. After surgery, clinicians can consider opioid alternatives such as nonsteroidal anti-inflammatory agents (NSAIDs). Neuropathic agents, such as gabapentin, require further research in their indications for managing postoperative pain. CPAP is typically held for a period of time after functional rhinoplasty. The decision on when to restart CPAP should be individualized to the patient based on their comorbidities, OSA severity, and surgical maneuvers performed. More research would provide further guidance in this patient population to shape more specific recommendations regarding their perioperative and intraoperative course.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Drug Induced Sleep Endoscopymentioning

confidence: 99%

Section: Drug-induced Sleep Endoscopymentioning

confidence: 99%

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