A Cadaveric Model for Measuring Continuous Positive Airway Pressure (CPAP) in the Nasal Cavity and Paranasal Sinuses: A Proof of Concept Study

2019 ◽  
Author(s):  
Ryan Rimmer ◽  
Chandala Chitguppi ◽  
Hermes Garcia ◽  
Ian Koszewski ◽  
Gurston Nyquist ◽  
...  
2018 ◽  
Vol 9 (2) ◽  
pp. 197-203 ◽  
Author(s):  
Ryan A. Rimmer ◽  
Chandala Chitguppi ◽  
Hermes G. Garcia ◽  
Ian J. Koszewski ◽  
Gurston G. Nyquist ◽  
...  

2020 ◽  
Vol 34 (4) ◽  
pp. 487-493 ◽  
Author(s):  
Erin K. Reilly ◽  
Colin T. Huntley ◽  
Maurits S. Boon ◽  
Gregory Epps ◽  
Swar Vimawala ◽  
...  

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.


Author(s):  
Alexander D. Blandford ◽  
Daniel G. Cherfan ◽  
Richard L. Drake ◽  
Jennifer M. McBride ◽  
Catherine J. Hwang ◽  
...  

2014 ◽  
Vol 24 (2) ◽  
pp. 48-58 ◽  
Author(s):  
Lakshmi Kollara ◽  
Graham Schenck ◽  
Jamie Perry

Studies have investigated the applications of Continuous Positive Airway Pressure (CPAP) therapy in the treatment of hypernasality due to velopharyngeal dysfunction (VPD; Cahill et al., 2004; Kuehn, 1991; Kuehn, Moon, & Folkins, 1993; Kuehn et al., 2002). The purpose of this study was to examine the effectiveness of CPAP therapy to reduce hypernasality in a female subject, post-traumatic brain injury (TBI) and pharyngeal flap, who presented with signs of VPD including persistent hypernasality. Improvements in mean velopharyngeal orifice size, subjective perception of hypernasality, and overall intelligibility were observed from the baseline to 8-week post-treatment assessment intervals. Additional long-term assessments completed at 2, 3, and 4 months post-treatment indicated decreases in immediate post-treatment improvements. Results from the present study suggest that CPAP is a safe, non-invasive, and relatively conservative treatment method for reduction of hypernasality in selected patients with TBI. More stringent long-term follow up may indicate the need for repeated CPAP treatment to maintain results.


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