scholarly journals Delayed CPAP-Induced Pneumocephalus and Meningitis Posttranssphenoidal Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Tara D’Ignazio ◽  
Mary Francispillai ◽  
Marc Giroux ◽  
Martin Albert
Keyword(s):  
Obstructive Sleep Apnea ◽  
Pituitary Adenoma ◽  
Sleep Apnea ◽  
Pituitary Adenomas ◽  
Transsphenoidal Surgery ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Obstructive Sleep ◽  
Exact Timing

Transsphenoidal surgery (TSS) is a frequently used technique to remove pituitary adenomas. Rare complications of TSS include development of postoperative pneumocephalus. Many patients undergoing TSS also suffer from obstructive sleep apnea (OSA) and thus require positive pressure ventilation. The exact timing of when to safely reintroduce the CPAP machine in this subset of patients is presently not exactly known but is most often cited as being two to four weeks postoperatively. In this case, we describe the story of a 69-year-old female who underwent TSS for a nonsecreting pituitary adenoma in April 2012 and went on to develop pneumocephalus five weeks postoperatively after reintroduction of her CPAP machine. This is the latest presentation of pneumocephalus after reintroduction of CPAP documented in present literature. The case reopens the debate as to how many weeks postoperatively positive pressure ventilation should be withheld to prevent the development of pneumocephalus in patients having undergone TSS with simultaneous OSA.

scholarly journals Resumption of Positive-Pressure Ventilation Devices for Obstructive Sleep Apnea following Transsphenoidal Surgery: An Institutional Experience of a Surgical Cohort

2019 ◽  
Vol 81 (03) ◽  
pp. 237-243 ◽  
Author(s):  
Nicholas Gravbrot ◽  
Heidi Jahnke ◽  
William L. White ◽  
Andrew S. Little
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Skull Base ◽  
Transsphenoidal Surgery ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Obstructive Sleep ◽  
Csf Leakage ◽  
Intracranial Complications ◽  
Institutional Experience

Objectives Transsphenoidal surgery creates a skull base defect that may cause postoperative cerebrospinal fluid (CSF) leakage or pneumocephalus. This study reviewed the institutional experience of a pituitary center in managing patients who use positive-pressure ventilation (PPV) devices for obstructive sleep apnea (OSA) after transsphenoidal surgery, which risks disturbing the skull base repair. Design Retrospective review. Setting Pituitary referral center in a major metropolitan medical center. Methods PPV was resumed at the discretion of the treatment team based on intraoperative findings and OSA severity. Perioperative complications related to resuming and withholding PPV were recorded. Participants Transsphenoidal surgery patients with OSA using PPV devices. Main Outcome Measures Intracranial complications before and after resuming PPV. Results A total of 42 patients met the study criteria. Intraoperative CSF leakage was encountered and repaired in 20 (48%) patients. Overall, 38 patients resumed PPV (median: 3.5 weeks postsurgery; range: 0.14–52 weeks) and 4 patients did not resume PPV. Postoperatively, no patient experienced CSF leakage or pneumocephalus before or after resuming PPV. Four (10%) patients required temporary nocturnal supplemental oxygen at home, one patient was reintubated after a myocardial infarction, and one patient had a prolonged hospital stay due to chronic obstructive pulmonary disease exacerbation. Conclusions Resuming PPV use after transsphenoidal surgery did not result in intracranial complications. However, delay in resuming PPV resulted in four patients requiring oxygen at home. We propose a preliminary PPV device management algorithm based on the size of the intraoperative CSF leak to facilitate future studies.

Implementing Non-Invasive Positive Pressure Ventilation for Known and at Risk Obstructive Sleep Apnea Surgical Patients

2015 ◽  
Vol 30 (4) ◽  
pp. e5
Author(s):  
Kimberly Latham ◽  
Tamera Bird ◽  
Joyce Burke ◽  
Molly Johantgen ◽  
Victoria Martin ◽  
...  
Keyword(s):  
At Risk ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Positive Pressure Ventilation ◽  
Surgical Patients ◽  
Positive Pressure ◽  
Non Invasive ◽  
Obstructive Sleep

Predictors of daytime hypercapnia in obstructive sleep apnea patients. Effect of treatment with noninvasive positive pressure ventilation

2017 ◽  
Vol 40 ◽  
pp. e308
Author(s):  
D. Siopi ◽  
M. Agrafiotis ◽  
M. Antoniadou ◽  
E. Nena ◽  
A. Galanou ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Obstructive Sleep ◽  
Effect Of Treatment

Treatment of Obstructive Sleep Apnea with Positive Pressure Ventilation

2013 ◽  
Vol 33 (4) ◽  
pp. 239 ◽  
Author(s):  
Jihye Choi ◽  
Seok Hyun Cho
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Obstructive Sleep

scholarly journals The Association between Obstructive Sleep Apnea and Neurocognitive Performance—The Apnea Positive Pressure Long-term Efficacy Study (APPLES)

SLEEP ◽  
2011 ◽  
Vol 34 (3) ◽  
pp. 303-314 ◽  
Author(s):  
Stuart F. Quan ◽  
Cynthia S. Chan ◽  
William C. Dement ◽  
Alan Gevins ◽  
James L. Goodwin ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Positive Pressure ◽  
Efficacy Study ◽  
Neurocognitive Performance ◽  
Term Efficacy ◽  
Obstructive Sleep
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