Surgical Preparation

As with any surgery, ensuring that a patient is medically stable for the operative procedure can reduce postoperative complications. This evaluation includes appropriate laboratory, cardiopulmonary, and radiographic testing. In patients with existing comorbid medical conditions (diabetes, hypothyroidism, cardiovascular disease, and pulmonary disease), consultation with the appropriate medical specialist should be sought.

Furthermore, for those patients who are tolerant of CPAP, they should be encouraged to use this modality for at least two weeks prior to surgery. Preoperative CPAP can alleviate the issues associated with sleep deprivation and may reduce the risk of postobstructive pulmonary edema (50). In 1988, Powell et al. (51) recommended the use of preoperative CPAP for all patients who have an RDI greater than 40 and an oxygen desaturation of 80% or less. According to this protocol, the surgeon must consider insertion of a temporary tracheotomy for those patients with severe OSA (RDI greater than 60 and/or SaO2 less than 70%) who are intolerant of CPAP therapy. Tracheotomy is rarely needed at our center and must be determined on a case-by-case basis.

Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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