This study examines practice patterns and expert opinion on the use of postoperative CPAP and nasal saline in patients with OSA.

A 14-item survey was generated by consensus among expert authors and distributed online to members of the North American Skull Base Society and other international skull base community members. Data were analyzed for median, mean, and standard deviation variables. Subgroup analysis was completed between surgeons from different geographical locations and operative experience. 

In patients with OSA, respondents would resume patients’ CPAP therapy after a mean of 10.1 days, without a CSF leak. In the presence of a small CSF leak, the mean duration would increase to 14.3 days and 20.7 days because of a more extensive leak. Researchers found a surgeon’s choice to attribute the relationship between delaying the start of nasal saline and CPAP after the endoscopic skull base surgery with progressively more challenging skull base repair to be statistically significant.

Saline and CPAP therapies are initiated after the endoscopic skull base surgical repairs by surgeons, increasing temporal delay concerning the skull base defect’s degree and complexity.