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Acoustic rhinometry predicts tolerance of nasal continuous positive airway pressure: a pilot study.
Am J Rhinol. 2006 Mar-Apr; 20(2):133-7.AJ

Abstract

BACKGROUND

Nasal continuous positive airway pressure (nCPAP) is usually the first-line intervention for obstructive sleep apnea, but up to 50% of patients are unable to tolerate therapy because of discomfort-usually nasal complaints. No factors have been definitively correlated with nCPAP tolerance, although nasal cross-sectional area has been correlated with the level of CPAP pressure, and nasal surgery improves nCPAP compliance. This study examined the relationship between nasal cross-sectional area and nCPAP tolerance.

METHODS

We performed acoustic rhinometry on 34 obstructive sleep apnea patients at the time of the initial sleep study. Patients titrated to nCPAP were interviewed 18 months after starting therapy to determine CPAP tolerance. Demographic, polysomnographic, and nasal cross-sectional area data were compared between CPAP-tolerant and -intolerant patients.

RESULTS

Between 13 tolerant and 12 intolerant patients, there were no significant differences in age, gender, body mass index, CPAP level, respiratory disturbance index, or subjective nasal obstruction. Cross-sectional area at the inferior turbinate differed significantly between the two groups (p = 0.03). This remained significant after multivariate analysis for possibly confounding variables. A cross-sectional area cutoff of 0.6 cm2 at the head of the inferior turbinate carried a sensitivity of 75% and specificity of 77% for CPAP intolerance in this patient group.

CONCLUSION

Nasal airway obstruction correlated with CPAP tolerance, supporting an important role for the nose in CPAP, and providing a physiological basis for improved CPAP compliance after nasal surgery. Objective nasal evaluation, but not the subjective report of nasal obstruction, may be helpful in the management of these patients.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, NY 10016, USA. luc.morris@med.nyu.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16686374

Citation

Morris, Luc G., et al. "Acoustic Rhinometry Predicts Tolerance of Nasal Continuous Positive Airway Pressure: a Pilot Study." American Journal of Rhinology, vol. 20, no. 2, 2006, pp. 133-7.
Morris LG, Setlur J, Burschtin OE, et al. Acoustic rhinometry predicts tolerance of nasal continuous positive airway pressure: a pilot study. Am J Rhinol. 2006;20(2):133-7.
Morris, L. G., Setlur, J., Burschtin, O. E., Steward, D. L., Jacobs, J. B., & Lee, K. C. (2006). Acoustic rhinometry predicts tolerance of nasal continuous positive airway pressure: a pilot study. American Journal of Rhinology, 20(2), 133-7.
Morris LG, et al. Acoustic Rhinometry Predicts Tolerance of Nasal Continuous Positive Airway Pressure: a Pilot Study. Am J Rhinol. 2006;20(2):133-7. PubMed PMID: 16686374.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acoustic rhinometry predicts tolerance of nasal continuous positive airway pressure: a pilot study. AU - Morris,Luc G, AU - Setlur,Jennifer, AU - Burschtin,Omar E, AU - Steward,David L, AU - Jacobs,Joseph B, AU - Lee,Kelvin C, PY - 2006/5/12/pubmed PY - 2006/12/9/medline PY - 2006/5/12/entrez SP - 133 EP - 7 JF - American journal of rhinology JO - Am J Rhinol VL - 20 IS - 2 N2 - BACKGROUND: Nasal continuous positive airway pressure (nCPAP) is usually the first-line intervention for obstructive sleep apnea, but up to 50% of patients are unable to tolerate therapy because of discomfort-usually nasal complaints. No factors have been definitively correlated with nCPAP tolerance, although nasal cross-sectional area has been correlated with the level of CPAP pressure, and nasal surgery improves nCPAP compliance. This study examined the relationship between nasal cross-sectional area and nCPAP tolerance. METHODS: We performed acoustic rhinometry on 34 obstructive sleep apnea patients at the time of the initial sleep study. Patients titrated to nCPAP were interviewed 18 months after starting therapy to determine CPAP tolerance. Demographic, polysomnographic, and nasal cross-sectional area data were compared between CPAP-tolerant and -intolerant patients. RESULTS: Between 13 tolerant and 12 intolerant patients, there were no significant differences in age, gender, body mass index, CPAP level, respiratory disturbance index, or subjective nasal obstruction. Cross-sectional area at the inferior turbinate differed significantly between the two groups (p = 0.03). This remained significant after multivariate analysis for possibly confounding variables. A cross-sectional area cutoff of 0.6 cm2 at the head of the inferior turbinate carried a sensitivity of 75% and specificity of 77% for CPAP intolerance in this patient group. CONCLUSION: Nasal airway obstruction correlated with CPAP tolerance, supporting an important role for the nose in CPAP, and providing a physiological basis for improved CPAP compliance after nasal surgery. Objective nasal evaluation, but not the subjective report of nasal obstruction, may be helpful in the management of these patients. SN - 1050-6586 UR - https://www.unboundmedicine.com/medline/citation/16686374/Acoustic_rhinometry_predicts_tolerance_of_nasal_continuous_positive_airway_pressure:_a_pilot_study_ DB - PRIME DP - Unbound Medicine ER -