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Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Scientific Oral Presentation 1 - Facial Plastics and Reconstructive Surgery

Respiratory Complications Following Septoplasty in Patients with OSA: Is it Necessary to Admit After Surgery?

Sunday, October 12, 2025
1:06 PM - 1:12 PM EDT
Location: 137
Disclosure(s):
Jeffrey Lorenz, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Septoplasty, one of the most frequently performed surgeries in otolaryngology, is commonly indicated to improve CPAP compliance in patients with obstructive sleep apnea (OSA). Concerns regarding postoperative respiratory complications, particularly in OSA patients, often lead to recommendations for overnight admission. This study investigates the incidence of respiratory complications after septoplasty in patients with OSA.

Methods: The TriNetX Research Network was queried using diagnosis and procedure codes to identify patients who underwent septoplasty during 2011-2023. The rate of postoperative acute hypoxemic respiratory failure (AHRF) and emergency department (ED) visits were tracked in OSA and non-OSA patients, matched for age, sex, race, and ethnicity.

Results: A total of 117,812 patients underwent septoplasty, 23.5% (n=27,742) of whom had a history of OSA. After matching, the average age of both cohorts was 47.8 years, with 66.4% male. Postoperatively, 21.3% (n=5,920) of OSA patients were admitted overnight, compared to 17.9% (n=16,135) of non-OSA patients. The incidence of postoperative AHRF within the first day postoperatively was higher in OSA patients (0.27% vs. 0.09%, RR 2.89, 95% CI 1.85-4.51, P< 0.001), as was the rate between days 2–30 (0.21% vs. 0.10%, RR 2.14, 95% CI 1.37-3.36, P< 0.001). Additionally, OSA patients had a significantly higher rate of ED visits within the first month postoperatively (4.55% vs. 2.43%, RR 1.87, 95% CI 1.71-2.05, P< 0.001).

Conclusions: Although the risk of acute hypoxemic respiratory failure is significantly higher in OSA patients following septoplasty, the overall incidence remains very low. Given these findings, and unless other contraindications exist, septoplasty may be considered safe for outpatient surgery in most OSA patients, and the necessity of overnight admission should be re-evaluated.

    Presenting Author(s)

  • Jeffrey Lorenz, MD

    Resident
    Penn State College of Medicine, Department of Otolaryngology – Head and Neck Surgery
    Hershey, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Cheng Ma, MD

    Resident Physician
    Penn State University/ Milton S. Hershey Medical Center
    Harrisburg, PA, United States

    Disclosure information not submitted.

  • Aniruddha Parikh, MD

    Resident
    University of Oklahoma Health Sciences Center
    Oklahoma City, Oklahoma, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • SW

    Scott Walen, MD, FRCSC

    Penn State Health Department of Otolaryngology - Head and Neck Surgery, United States

    Disclosure information not submitted.