Nasal Surgery and CPAP tolerance

[Norman2195]

Hi All,

10 months on CPAP now and suffered greatly from aerophaiga and mouth leaks. Did no tolerate the full face mask well and it actually led to worse results.

I visited an ENT who looked up my nose and found significant swelling in my turbinates (i have allergies), deviated septum and also significant adnoid tissue.

I was wondering if anyone else had nasal surgery to treat the above listed areas to improve nasal airflow and what effect that had on their CPAP treatment.

Less aerophagia and mouth leaks hopefully? I will be getting my surgery in a week so fingers crossed it all goes well.

Kind regards,
N.

[BoxcarPete]

Let me know how it goes. I have intermittent mouth leak issues as well, and had some similar work done in my childhood (tonsils and adenoids removed). I've read that enlarged adenoids sometimes come back, so I've been considering going into an ENT who is also a sleep specialist to be evaluated for exactly this kind of thing.

Sorry I can't help, but I'll be cheering for you!

[Jay51]

I had surgery to correct a deviated septum and inferior turbinate reduction about a month ago. I tried to get the Latera implants to stop nasal valve collapse also, but my insurance denied that.   So far it has not helped aerophagia at all.  Leaks are still the same also (I use a ventilator with high PS though).  And actually, no noticeable difference in regards to mucous (phlegm) either.  

I can tell a difference using my ventilator at night breathing though.  My left nostril used to completely clog even when using the ventilator.  Not any more.  I do feel I am getting better airflow in both inhalation and exhalation (at least 100% better in my left nostril and possibly 50% better in my right nostril) - just guesses though.  But how much better really though?  That remains to be seen.  I have never seen any study that shows how much correcting a deviated septum (or even turbinate reduction) helps with sleep apnea treatment.  I have months worth of naps on my s9 Adapt ASV with OSCAR charts.  My plan here pretty soon is to try to reproduce the exact same scenario with the same set up and same pressures and same equipment, etc. (but this time with deviated septum corrected and turbinate reduction) and compare OSCAR charts to see if there are any significant changes in the values.

[CPAPfriend]

The literature demonstrates that certain nasal surgeries that increase nasal airway patency can improve CPAP compliance and efficacy. Surgery should obviously be suggested on a case-by-case basis, but the overall best surgery for poor nasal airways seems to be maxillary expansion. I'm not doubting your doctor's treatment plan, but it's worthwhile to get a few different opinions about something so serious.

I read a small study where all patients eliminated aerophagia with either a chinstrap, EPR, or bilevel, for what it's worth.

[punkrockcholo]

Norman, how did the surgery go?

Jay, how long was the recovery after your surgery? Were you able to use cpap immediately or did you need to take a break from it during the healing?

[Norman2195]

Hi!

The surgery went really well and I am now two weeks post surgery.

I've just been able to start using my CPAP machine as for the first two weeks my lose was basically blocked because of bleeding and swelling.  

Overall the first week of recovery is pretty painful, but into the second week of recovery everything becomes much more manageable. 

My nasal airflow has improved tremendously, i really had no idea what it was like to breathe through my nose before hand. Highly recommend this surgery.

As for CPAP effects, as i said its still very early days. I heard it could take up to 3 months before swelling dies down completely and my nasal airway achieves the full benefit of surgery. 

I will report again in a months time with hopefully more news.

Kind regards,
N.

[Jay51]

Congratulations Norman.  The 1st couple of days were really tough.  Lots of blood and mucus drainage.  About a week or 2 after surgery, like Norman, I was breathing much better.  When the Anesthesiologist interviewed me before my surgery, I told her about my complex apnea, hypoventilation, heart issues, etc.  She made an exception in my case.  Usually, the ENT wanted at least a week off of any pap after this particular surgery.  Both ENT and Anesthesiologist wanted me to continue using my ventilator the same night after surgery.  I never had a day off from it.  ENT said my nose looked fine and straight in the follow up appointment, so it worked out ok.