Abstract
Background: To describe current practice in terms of perioperative
management routines used by otolaryngologists who practice obstructive
sleep apnea (OSA) surgical management. Methods: The study comprises an
international, web-based, cross-sectional survey. The authors surveyed
otolaryngologists and maxillofacial surgeons who practice OSA surgical
management worldwide, using an in-house designed survey tool. We
developed a new measure called “experience” (years x patients per
year) and found no correlations with specific recommendations. Results:
The response rate was 62%, with 81% reporting no postoperative oxygen
and 83% no use of postoperative positive airway pressure (PAP) support.
Regarding hospitalization stays, for palatal surgeries, 43 (88% ) of
respondents discharge patients under 24 hours postoperatively, while in
multi-level surgeries, 14% discharge patients after 4-7 days of
hospitalization. Only 59% of respondents reported using opioids for
pain management, 82% administered prophylactic antibiotics, and 86%
said they routinely prescribed steroids. In investigating the different
correlations and various postoperative management decisions, we did not
find any significant differences among groups with few exceptions: (1) a
positive correlation between prescribing prophylactic antibiotics
(Pv=0.043) and recommending postoperative oxygen support (Pv=0.01) among
physicians who prescribe pre-operative steroids, and (2) for physicians
who recommend postoperative oxygen support, a positive correlation
between recommending postoperative PAP support (Pv=0.03) and intensive
care unit or intermediate unit monitoring (Pv=0.02). Conclusion: This
survey study elucidated the heterogeneity of pre-operative and
postoperative management tools for surgical patients suffering from OSA
who undergo surgical intervention. Keywords: Obstructive Sleep Apnea;
postoperative management; postoperative monitoring; antibiotic; steroids