ABSTRACT
While the guidelines for monitoring OSA patients post-operatively remain controversial, the use of tracheotomy or nasal CPAP for patients with severe sleep apnea has become a widely accepted practice. The preoperative polysomnogram (PSG) is most useful in determining the indications for the use of these two techniques. Tracheotomy, the first therapeutic procedure described for OSA, was previously the gold standard for treatment of patients with OSA (discussed in detail in another chapter). With the advent of CPAP, however, tracheotomy is usually reserved for definitive treatment only in patients with severe sleep apnea, and is rarely used for perioperative airway protection.
