Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
October 13, 2026 · via Europe PMC
Immediate Resumption of Positive Airway Pressure Following Sinus Surgery: A Prospective Controlled Multicenter Study.
Choby G, Mattos JL, O'Brien EK, +7 more, Stokken J.
AI summary — for doctors, generated from the abstract only
Restarting PAP therapy on the day of or after sinus surgery was not associated with worse endoscopic scores, symptoms or epistaxis in this prospective study.
What was studied
Multicentre prospective controlled study of 100 patients: 49 with OSA who resumed PAP on postoperative day 0 or 1 versus 51 non-OSA controls undergoing FESS.
Key findings
- Primary outcome Lund-Kennedy endoscopic score was not higher in the PAP group at either postoperative visit after adjustment.
- SNOT-22 and epistaxis scores were likewise not higher.
- There were no PAP-related complications such as orbital emphysema or pneumocephalus.
Clinical relevance
These results suggest that sleep apnea patients need not routinely delay PAP after sinus surgery for fear of poorer healing or bleeding, supporting perioperative treatment of sleep apnea.
Who should care
Limitations
The comparison was with non-OSA controls rather than randomised, the sample was 100 patients, and rare complications could be missed. Numerical effect estimates and confidence intervals are not given in the abstract.
Resuming PAP on the day of or after sinus surgery was not associated with worse endoscopic scores, quality of life or epistaxis in this cohort.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
Untreated obstructive sleep apnea (OSA) in the perioperative period confers significant cardiopulmonary risk. However, many otolaryngologists defer restarting positive airway pressure (PAP) therapy following functional endoscopic sinus surgery (FESS) due to perceived risk of epistaxis, mucosal injury, and wound healing. Thus, the objective of this study was to evaluate the immediate resumption of PAP therapy in OSA patients undergoing FESS.
Study design
Multicenter prospective controlled study.
Setting
Academic medical centers.
Methods
Patients with a history of OSA on PAP therapy scheduled for FESS were prospectively enrolled (OSA/PAP group) along with a control group of non-OSA FESS patients (non-OSA group). Patients in the OSA/PAP group restarted PAP therapy on post-operative Day #0 or #1. The primary outcome was change in Lund-Kennedy endoscopic scores (LKES); secondary outcomes of interest included change in post-operative SNOT-22 scores, Pittsburgh Sleep Quality Index (PSQI) scores, complications, and epistaxis severity scores.
Results
A total of 100 patients were enrolled, of whom 49 were in the OSA/PAP group, and 51 were in the non-OSA group. In multivariate adjusted models, early PAP resumption was not independently associated with higher LKES compared to the control group at POV1 or POV2, higher SNOT-22 compared to the control group at POV1 or POV2, or higher postoperative epistaxis scores compared to the control group. There were no PAP-related complications such as orbital emphysema or pneumocephalus.
Conclusion
Early resumption of PAP in OSA patients undergoing FESS does not appear to be associated with worsened post-operative endoscopic scores, quality-of-life scores, or an increased risk of post-operative epistaxis.
DOI
10.1002/ohn.70496
PMID
42867257
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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