Rhinoplasty and Sleep Apnea
Rhinoplasty may be requested to improve the aesthetics of the nose, but will it improve sleep apnea along the way? Sleep Apnea is a condition that affects many people and may be caused by a genetic defect or blockage in one or more the pathways responsible for providing oxygen to the body. The nose accounts for up to 40% of the airway system and people are often not aware that their nasal breathing problems may be contributed to deformed cartilage, scar tissue, excessive bone, or a crooked septum that impedes oxygen flow.
It may appear reasonable to assume that rhinoplasty patients may experience functional improvement of the nose after surgery should interference from a pre-surgery deformity be the cause of sleep apnea and it is treated during rhinoplasty. This can be appealing from a financial perspective as well. When rhinoplasty is performed for functional purposes, insurance may cover the costs associated with the procedure.
Selecting the Right Surgeon for Sleep Apnea Rhinoplasty Patients
True functional needs for the nose should be formally addressed through interdisciplinary expertise by a board certified ear nose and throat surgeon or otolaryngologist. Ear nose and throat surgeons who focus on sleep apnea understand all aspects that may limit the functioning of the nose. Otolaryngologists may have additional training for aesthetic needs. By the same token, plastic surgeons have advanced training in aesthetic surgery to help produce the most aesthetically desirable outcomes and a select number of plastic surgeons that have specific expertise for functional aspects of the nose as well. In addition, sleep apnea can be confirmed by a sleep specialist. It is important to note that there are special considerations when it comes to performing rhinoplasty surgery on sleep apnea patients.
Knowing the Signs of Sleep Apnea
People with sleep apnea may show signs of sleep apnea through excessive daytime sleepiness, frequent waking during sleep, GERD, morning headaches, and decreased cognitive daytime functioning. Diagnosis for sleep apnea involves a patient history intake and a multiple channel polysomography tests. Sleep Apnea symptoms are often discovered by a spouse or significant other who complains about their partner’s snoring, gasping or choking during sleep.
Pre and Post Op Precautions for Sleep Apnea
Plastic surgeons take additional precautions when performing rhinoplasty on a patient with sleep apnea. First, the anesthesiologist will evaluate the airways of a sleep apnea rhinoplasty patient prior to rhinoplasty surgery. After surgery, the plastic surgeon and anesthesiologist may advise using a CPAP machine to improve breathing in the recovery room and at home. CPAP stands for continuous positive airway pressure device. It is a mask that is worn over the nose to provide oxygen to the patient during sleep. Sleep apnea patients may use the CPAP on an ongoing basis at home to treat sleep apnea. Rhinoplasty patients with sleep apnea should be resting in a 45 degree angle upright position after surgery and up to 60 degrees at home. Because sleep apnea patients are more sensitive to pain medication and sedatives, patients will be monitored for respiratory depression after surgery.