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A cadaveric model for measuring sinonasal continuous positive airway pressure—a proof‐of‐concept study
Author(s) -
Rimmer Ryan A.,
Chitguppi Chandala,
Garcia Hermes G.,
Koszewski Ian J.,
Nyquist Gurston G.,
Rosen Marc R.,
Huntley Colin,
Evans James J.,
Rabinowitz Mindy R.
Publication year - 2019
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.22235
Subject(s) - medicine , cadaveric spasm , cadaver , continuous positive airway pressure , skull , sinus (botany) , positive pressure , intracranial pressure , cribriform plate , nasal cavity , neurosurgery , obstructive sleep apnea , surgery , anesthesia , botany , biology , genus
Background Obstructive sleep apnea is a common respiratory disorder that can have negative effects on health and quality of life. Positive pressure therapy (CPAP) is the primary treatment. There is a lack of consensus on the risk of postoperative CPAP after endoscopic sinus or skull base surgery. We present a proof‐of‐concept cadaver model for measuring sinonasal pressure delivered by CPAP. Methods Three fresh cadaver heads were prepared by removing the calvaria and brain. Sphenoidotomies were made and sellar bone was removed. Pressure sensors were placed in the midnasal cavity, sphenoid sinus, and sella. CPAP was applied and the delivered pressure was recorded at increasing levels of positive pressure. Paired t tests and intraclass correlation coefficients were used to analyze results. Results Increases in positive pressure led to increased pressure recordings for all locations. Nasal cavity pressure was, on average, 81% of delivered CPAP. Pressure was highest in the sphenoid sinus. The effect of middle turbinate medialization on intrasphenoid pressure was not statistically significant in 2 heads. Intrasellar pressure was 80% of delivered CPAP with lateralized turbinates and 84% with medialized turbinates. Pressure recordings demonstrated excellent reliability for all locations. All heads developed non‒sellar‐based cranial base leaks at higher pressures. Cribriform region leaks were successfully sealed with DuraSeal®. Conclusion Our proof‐of‐concept cadaver model represents a novel approach to measure pressures delivered to the nasal cavity and anterior skull base by CPAP. With further study, it may have broader clinical application to guide the safe postoperative use of CPAP in this population.