Qualitative Assessment of the Effect of Continuous Positive Airway Pressure on the Nasal Cavity
Background For patients with obstructive sleep apnea (OSA), there is a lack of knowledge regarding the impact of continuous positive airway pressure (CPAP) on the nasal cavity. There is a significant need for evidence-based recommendations regarding the appropriate use of CPAP following endoscopic s...
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| Veröffentlicht in: | American journal of rhinology & allergy 2020-07, Vol.34 (4), p.487-493 |
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| container_title | American journal of rhinology & allergy |
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| creator | Reilly, Erin K. Huntley, Colin T. Boon, Maurits S. Epps, Gregory Vimawala, Swar Chitguppi, Chandala Patel, Jena Murphy, Kira Nyquist, Gurston G. Rosen, Marc R. Evans, James J. Rabinowitz, Mindy R. |
| description | Background
For patients with obstructive sleep apnea (OSA), there is a lack of knowledge regarding the impact of continuous positive airway pressure (CPAP) on the nasal cavity. There is a significant need for evidence-based recommendations regarding the appropriate use of CPAP following endoscopic sinus and skull base surgery.
Objective
The goal of this study is to translate a previously developed cadaveric model for evaluating CPAP pressures in the sinonasal cavity by showing safety in vivo and quantifying the effect of positive pressurized air flow on the nasal cavity of healthy individuals where physiologic effects are at play.
Methods
A previously validated cadaveric model using intracranial sensor catheters has proved to be a reliable technique for measuring sinonasal pressures. These sensors were placed in the nasal cavity of 18 healthy individuals. Pressure within the nose was recorded at increasing levels of CPAP.
Results
Overall, nasal cavity pressure was on average 85% of delivered CPAP. The amount of pressure delivered to the nasal cavity increased as the CPAP increased. The percentage of CPAP delivered was 77% for 5 cmH2O and increased to 89% at 20 cmH2O. There was a significant difference in mean intranasal pressures between all the levels of CPAP except 5 cmH2O and 8 cmH2O (P |
| doi_str_mv | 10.1177/1945892420908749 |
| format | Article |
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For patients with obstructive sleep apnea (OSA), there is a lack of knowledge regarding the impact of continuous positive airway pressure (CPAP) on the nasal cavity. There is a significant need for evidence-based recommendations regarding the appropriate use of CPAP following endoscopic sinus and skull base surgery.
Objective
The goal of this study is to translate a previously developed cadaveric model for evaluating CPAP pressures in the sinonasal cavity by showing safety in vivo and quantifying the effect of positive pressurized air flow on the nasal cavity of healthy individuals where physiologic effects are at play.
Methods
A previously validated cadaveric model using intracranial sensor catheters has proved to be a reliable technique for measuring sinonasal pressures. These sensors were placed in the nasal cavity of 18 healthy individuals. Pressure within the nose was recorded at increasing levels of CPAP.
Results
Overall, nasal cavity pressure was on average 85% of delivered CPAP. The amount of pressure delivered to the nasal cavity increased as the CPAP increased. The percentage of CPAP delivered was 77% for 5 cmH2O and increased to 89% at 20 cmH2O. There was a significant difference in mean intranasal pressures between all the levels of CPAP except 5 cmH2O and 8 cmH2O (P < .001).
Conclusion
On average, only 85% of the pressure delivered by CPAP is transmitted to the nasal cavity. Higher CPAP pressures delivered a greater percentage of pressurized air to the nasal cavity floor. Our results are comparable to the cadaver model, which demonstrated similar pressure delivery even in the absence of anatomic factors such as lung compliance, nasal secretions, and edema. This study demonstrates the safety of using sensors in the human nasal cavity. This technology can also be utilized to evaluate the resiliency of various repair techniques for endoscopic skull base surgery with CPAP administration.</description><identifier>ISSN: 1945-8924</identifier><identifier>EISSN: 1945-8932</identifier><identifier>DOI: 10.1177/1945892420908749</identifier><identifier>PMID: 32102551</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Administration, Intranasal ; Adult ; Cadaver ; Continuous Positive Airway Pressure - methods ; Endoscopy ; Evidence-Based Medicine ; Female ; Humans ; Male ; Models, Anatomic ; Nasal Cavity - physiology ; Postoperative Complications - therapy ; Skull Base - surgery ; Sleep Apnea, Obstructive - etiology ; Sleep Apnea, Obstructive - prevention & control</subject><ispartof>American journal of rhinology & allergy, 2020-07, Vol.34 (4), p.487-493</ispartof><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-8d789e8f0128061132a2c0b6ed1329eaf7fd7871cb62cf5822b1c40ef060d27b3</citedby><cites>FETCH-LOGICAL-c337t-8d789e8f0128061132a2c0b6ed1329eaf7fd7871cb62cf5822b1c40ef060d27b3</cites><orcidid>0000-0003-0609-7002 ; 0000-0002-6882-1476</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1945892420908749$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1945892420908749$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,777,781,21800,27905,27906,43602,43603</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32102551$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Reilly, Erin K.</creatorcontrib><creatorcontrib>Huntley, Colin T.</creatorcontrib><creatorcontrib>Boon, Maurits S.</creatorcontrib><creatorcontrib>Epps, Gregory</creatorcontrib><creatorcontrib>Vimawala, Swar</creatorcontrib><creatorcontrib>Chitguppi, Chandala</creatorcontrib><creatorcontrib>Patel, Jena</creatorcontrib><creatorcontrib>Murphy, Kira</creatorcontrib><creatorcontrib>Nyquist, Gurston G.</creatorcontrib><creatorcontrib>Rosen, Marc R.</creatorcontrib><creatorcontrib>Evans, James J.</creatorcontrib><creatorcontrib>Rabinowitz, Mindy R.</creatorcontrib><title>Qualitative Assessment of the Effect of Continuous Positive Airway Pressure on the Nasal Cavity</title><title>American journal of rhinology & allergy</title><addtitle>Am J Rhinol Allergy</addtitle><description>Background
For patients with obstructive sleep apnea (OSA), there is a lack of knowledge regarding the impact of continuous positive airway pressure (CPAP) on the nasal cavity. There is a significant need for evidence-based recommendations regarding the appropriate use of CPAP following endoscopic sinus and skull base surgery.
Objective
The goal of this study is to translate a previously developed cadaveric model for evaluating CPAP pressures in the sinonasal cavity by showing safety in vivo and quantifying the effect of positive pressurized air flow on the nasal cavity of healthy individuals where physiologic effects are at play.
Methods
A previously validated cadaveric model using intracranial sensor catheters has proved to be a reliable technique for measuring sinonasal pressures. These sensors were placed in the nasal cavity of 18 healthy individuals. Pressure within the nose was recorded at increasing levels of CPAP.
Results
Overall, nasal cavity pressure was on average 85% of delivered CPAP. The amount of pressure delivered to the nasal cavity increased as the CPAP increased. The percentage of CPAP delivered was 77% for 5 cmH2O and increased to 89% at 20 cmH2O. There was a significant difference in mean intranasal pressures between all the levels of CPAP except 5 cmH2O and 8 cmH2O (P < .001).
Conclusion
On average, only 85% of the pressure delivered by CPAP is transmitted to the nasal cavity. Higher CPAP pressures delivered a greater percentage of pressurized air to the nasal cavity floor. Our results are comparable to the cadaver model, which demonstrated similar pressure delivery even in the absence of anatomic factors such as lung compliance, nasal secretions, and edema. This study demonstrates the safety of using sensors in the human nasal cavity. This technology can also be utilized to evaluate the resiliency of various repair techniques for endoscopic skull base surgery with CPAP administration.</description><subject>Administration, Intranasal</subject><subject>Adult</subject><subject>Cadaver</subject><subject>Continuous Positive Airway Pressure - methods</subject><subject>Endoscopy</subject><subject>Evidence-Based Medicine</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Models, Anatomic</subject><subject>Nasal Cavity - physiology</subject><subject>Postoperative Complications - therapy</subject><subject>Skull Base - surgery</subject><subject>Sleep Apnea, Obstructive - etiology</subject><subject>Sleep Apnea, Obstructive - prevention & control</subject><issn>1945-8924</issn><issn>1945-8932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kDtPwzAUhS0EoqWwMyGPLAHbcWJnrKrykBAUCWbLSa4hVRIX2ynqvydtSgckpvvQd47uPQhdUnJDqRC3NOOJzBhnJCNS8OwIjberSGYxOz70jI_QmfdLQlKecHqKRjGjhCUJHSP12um6CjpUa8BT78H7BtqArcHhE_DcGCh208y2oWo723m8sL4a-Mp96w1euF7VOcC23Ymetdc1nul1FTbn6MTo2sPFvk7Q-938bfYQPb3cP86mT1ERxyJEshQyA2kIZZKklMZMs4LkKZR9m4E2wvSEoEWessIkkrGcFpyAISkpmcjjCboefFfOfnXgg2oqX0Bd6xb6mxWL0zTlhHPRo2RAC2e9d2DUylWNdhtFidrGqv7G2kuu9u5d3kB5EPzm2APRAHj9AWppO9f23_5v-AOMFX9U</recordid><startdate>202007</startdate><enddate>202007</enddate><creator>Reilly, Erin K.</creator><creator>Huntley, Colin T.</creator><creator>Boon, Maurits S.</creator><creator>Epps, Gregory</creator><creator>Vimawala, Swar</creator><creator>Chitguppi, Chandala</creator><creator>Patel, Jena</creator><creator>Murphy, Kira</creator><creator>Nyquist, Gurston G.</creator><creator>Rosen, Marc R.</creator><creator>Evans, James J.</creator><creator>Rabinowitz, Mindy R.</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0609-7002</orcidid><orcidid>https://orcid.org/0000-0002-6882-1476</orcidid></search><sort><creationdate>202007</creationdate><title>Qualitative Assessment of the Effect of Continuous Positive Airway Pressure on the Nasal Cavity</title><author>Reilly, Erin K. ; Huntley, Colin T. ; Boon, Maurits S. ; Epps, Gregory ; Vimawala, Swar ; Chitguppi, Chandala ; Patel, Jena ; Murphy, Kira ; Nyquist, Gurston G. ; Rosen, Marc R. ; Evans, James J. ; Rabinowitz, Mindy R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-8d789e8f0128061132a2c0b6ed1329eaf7fd7871cb62cf5822b1c40ef060d27b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Administration, Intranasal</topic><topic>Adult</topic><topic>Cadaver</topic><topic>Continuous Positive Airway Pressure - methods</topic><topic>Endoscopy</topic><topic>Evidence-Based Medicine</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Models, Anatomic</topic><topic>Nasal Cavity - physiology</topic><topic>Postoperative Complications - therapy</topic><topic>Skull Base - surgery</topic><topic>Sleep Apnea, Obstructive - etiology</topic><topic>Sleep Apnea, Obstructive - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Reilly, Erin K.</creatorcontrib><creatorcontrib>Huntley, Colin T.</creatorcontrib><creatorcontrib>Boon, Maurits S.</creatorcontrib><creatorcontrib>Epps, Gregory</creatorcontrib><creatorcontrib>Vimawala, Swar</creatorcontrib><creatorcontrib>Chitguppi, Chandala</creatorcontrib><creatorcontrib>Patel, Jena</creatorcontrib><creatorcontrib>Murphy, Kira</creatorcontrib><creatorcontrib>Nyquist, Gurston G.</creatorcontrib><creatorcontrib>Rosen, Marc R.</creatorcontrib><creatorcontrib>Evans, James J.</creatorcontrib><creatorcontrib>Rabinowitz, Mindy R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of rhinology & allergy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reilly, Erin K.</au><au>Huntley, Colin T.</au><au>Boon, Maurits S.</au><au>Epps, Gregory</au><au>Vimawala, Swar</au><au>Chitguppi, Chandala</au><au>Patel, Jena</au><au>Murphy, Kira</au><au>Nyquist, Gurston G.</au><au>Rosen, Marc R.</au><au>Evans, James J.</au><au>Rabinowitz, Mindy R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Qualitative Assessment of the Effect of Continuous Positive Airway Pressure on the Nasal Cavity</atitle><jtitle>American journal of rhinology & allergy</jtitle><addtitle>Am J Rhinol Allergy</addtitle><date>2020-07</date><risdate>2020</risdate><volume>34</volume><issue>4</issue><spage>487</spage><epage>493</epage><pages>487-493</pages><issn>1945-8924</issn><eissn>1945-8932</eissn><abstract>Background
For patients with obstructive sleep apnea (OSA), there is a lack of knowledge regarding the impact of continuous positive airway pressure (CPAP) on the nasal cavity. There is a significant need for evidence-based recommendations regarding the appropriate use of CPAP following endoscopic sinus and skull base surgery.
Objective
The goal of this study is to translate a previously developed cadaveric model for evaluating CPAP pressures in the sinonasal cavity by showing safety in vivo and quantifying the effect of positive pressurized air flow on the nasal cavity of healthy individuals where physiologic effects are at play.
Methods
A previously validated cadaveric model using intracranial sensor catheters has proved to be a reliable technique for measuring sinonasal pressures. These sensors were placed in the nasal cavity of 18 healthy individuals. Pressure within the nose was recorded at increasing levels of CPAP.
Results
Overall, nasal cavity pressure was on average 85% of delivered CPAP. The amount of pressure delivered to the nasal cavity increased as the CPAP increased. The percentage of CPAP delivered was 77% for 5 cmH2O and increased to 89% at 20 cmH2O. There was a significant difference in mean intranasal pressures between all the levels of CPAP except 5 cmH2O and 8 cmH2O (P < .001).
Conclusion
On average, only 85% of the pressure delivered by CPAP is transmitted to the nasal cavity. Higher CPAP pressures delivered a greater percentage of pressurized air to the nasal cavity floor. Our results are comparable to the cadaver model, which demonstrated similar pressure delivery even in the absence of anatomic factors such as lung compliance, nasal secretions, and edema. This study demonstrates the safety of using sensors in the human nasal cavity. This technology can also be utilized to evaluate the resiliency of various repair techniques for endoscopic skull base surgery with CPAP administration.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>32102551</pmid><doi>10.1177/1945892420908749</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-0609-7002</orcidid><orcidid>https://orcid.org/0000-0002-6882-1476</orcidid></addata></record> |
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| ispartof | American journal of rhinology & allergy, 2020-07, Vol.34 (4), p.487-493 |
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| source | MEDLINE; SAGE Complete A-Z List; Alma/SFX Local Collection |
| subjects | Administration, Intranasal Adult Cadaver Continuous Positive Airway Pressure - methods Endoscopy Evidence-Based Medicine Female Humans Male Models, Anatomic Nasal Cavity - physiology Postoperative Complications - therapy Skull Base - surgery Sleep Apnea, Obstructive - etiology Sleep Apnea, Obstructive - prevention & control |
| title | Qualitative Assessment of the Effect of Continuous Positive Airway Pressure on the Nasal Cavity |
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