Background/Objectives: Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder associated with cognitive decline. Evidence regarding the reversibility of these deficits after continuous positive airway pressure (CPAP) therapy remains inconsistent. Methods: This prospective observational study included 60 adults with newly diagnosed moderate-to-severe OSA (median age 51 years; 80% male), who underwent baseline assessment using P300 event-related potentials and the Montreal Cognitive Assessment (MoCA). After three months of CPAP therapy with confirmed good compliance, both measures were re-evaluated. Results: After three months of CPAP therapy, a statistically significant reduction in P300 latency (p < 0.001) and an increase in amplitude were observed, accompanied by significant improvements in executive function (p < 0.001), attention (p < 0.001), and delayed recall (p < 0.001). Conclusions: CPAP therapy leads to measurable recovery of cognitive function in patients with moderate-to-severe OSA, suggesting partial reversibility of neurocognitive impairment associated with sleep-disordered breathing. These findings highlight the importance of early recognition and treatment of OSA to prevent long-term cognitive decline.

The aim of this study was to present the advantages and disadvantages of open approach in rhinoplasty. In it, we also present the development of this technique in Croatia and examine its application in the last five years at the Department of Otorhinolaryngology and Head and Neck Surgery of the Clinical Hospital Centre Osijek. Retrospectively, from January 2008 to August 2012, 400 patients with septal deviation and/or deformities of the nasal pyramid who underwent open rhinoplasty at the Department of Otorhinolaryngology, Head and Neck Surgery of the Clinical Hospital Centre of Osijek, Croatia were identified. The clinical diagnosis was based on a detailed medical history of the patient and nasal endoscopy. The patients were photographed in six projections before and after the surgery, and followed up on two occasions.

Background and Objectives: This study aimed to investigate the influence of continuous positive airway pressure in patients with obstructive sleep apnoea on hearing and the possibility of recovering cochlear receptor cells. Materials and Methods: Forty-two patients with obstructive sleep apnoea (OSA) were assigned to the study group. Patients underwent pure-tone audiometry and transient-evoked (TEOAE) and distortion-product (DPOAE) otoacoustic emissions before starting continuous positive airway pressure (CPAP) therapy and six months after CPAP therapy. Subjects were further divided into the following two groups: those who adequately used the therapy and those who did not adhere to treatment recommendations. Results: There is no significant difference in hearing thresholds for specific frequencies after six months of CPAP therapy. There is no significant difference in TEOAE and DPOAE SNR values at any frequency after 6 months of CPAP therapy. There is no significant difference in hearing threshold results for specific frequencies as a function of subject co-operation with treatment. After therapy, there is a significant difference in the SNR values in TEOAEs at 2 kHz and 4 kHz in subjects of the OSA target group, depending on co-operation, being higher in co-operative subjects, while there are no significant differences at other frequencies. There is a significant difference in the SNR results in DPOAEs, where they are higher in co-operative subjects at 1000, 6000, 7000 and 8000 Hz. Conclusions: The use of continuous positive airway pressure as a therapy for OSA has no effect on hearing and cochlear receptor cell recovery. Co-operation with CPAP treatment does not affect hearing threshold, but does affect cochlear receptor cell function, which is better at mid and higher frequencies in those who co-operate. These findings underscore the clinical significance of treatment adherence. Consistent adherence is associated with measurable improvements in hearing, particularly at higher frequencies, which cannot typically be evaluated in routine clinical practice using standard pure-tone audiometry. Our results emphasise the importance of promoting compliance with CPAP therapy not only for cardiovascular and neurological protection, but also for maintaining hearing health.

Background and Objectives: Cognitive deficits are common in obstructive sleep apnea (OSA), and both intermittent hypoxemia and cardiovascular comorbidity may contribute to poorer outcomes. Arterial hypertension (HTN) has been suggested as a potential modifier of cognitive function in OSA, but findings remain inconsistent. This study examined whether HTN influences baseline cognition or cognitive improvement after continuous positive airway pressure (CPAP) therapy in moderate-to-severe OSA and identified predictors of poorer post-treatment cognitive status. Materials and Methods: This prospective study involved 71 adults with newly diagnosed moderate-to-severe OSA (AHI ≥ 15). Participants underwent baseline polysomnography, Montreal Cognitive Assessment (MoCA) testing, and P300 assessments. Cognitive impairment was defined as MoCA < 26 and HTN by antihypertensive therapy, documented diagnosis, or repeatedly elevated blood pressure. All participants initiated auto-adjusting CPAP and were reassessed after three months for adherence, residual respiratory indices, MoCA, and P300 parameters. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were used to identify independent predictors of poorer cognitive outcomes. Results: CPAP therapy significantly improved apnea severity, daytime sleepiness, global cognition, and P300 latency, while P300 amplitude did not change significantly. After three months, hypertensive and normotensive patients showed similar MoCA scores, respiratory outcomes, and P300 amplitude; P300 latency remained marginally longer in hypertensive individuals. Across multivariate models, lower mean nocturnal oxygen saturation and reduced CPAP adherence independently predicted poorer cognitive outcome at follow-up. CPAP adherence demonstrated greater discriminative ability than mean nocturnal oxygenation. Conclusions: In adequately treated moderate-to-severe OSA, HTN did not significantly affect baseline cognition or short-term cognitive recovery with CPAP. Although P300 latency remained slightly prolonged in hypertensive individuals, this difference was marginal and not accompanied by cognitive deficits. Nocturnal oxygenation and CPAP adherence emerged as the strongest predictors of post-treatment cognitive status, underscoring the importance of sustained and effective therapy. These findings suggest that effective CPAP adherence and improved nocturnal oxygenation are crucial for cognitive recovery in OSA patients, regardless of hypertensive status.

Background: Road traffic accidents (RTAs) present a significant public health problem and economic burden. The aim of the study was to determine mental health outcomes and health-related quality of life (HRQOL) of RTA victims 6 months following a road trauma and factors associated with mental and physical components of HRQOL; Methods: A cohort of 200 RTA victims was followed during a 6-month period and a wide range of sociodemographic, health-related, RTA-related, injury-related, psychological and victim-related factors associated with the HRQOL scores were explored using multiple regression analyses; Results: Lower physical component summary score was associated with pre-existing chronic disease, self-perceived life threat, surgical treatment, amnesia following an RTA, permanent pain, increase in pain intensity or frequency and depression symptoms (p < 0.05); lower mental component summary score was associated with irreligiousness, rehabilitation procedure, depression symptoms, anxiety symptoms, permanent pain and increase in medication use (p < 0.05); Conclusions: HRQOL measurement after an RTA should provide holistic assessment of physical, mental and social consequences throughout an extended period of recovery. Together with evaluation of predictors of poorer HRQOL and recovery, this could enable an individual approach to individual needs of RTA victims.

Background: Nasal obstruction has been implicated in the pathophysiology of obstructive sleep apnoea (OSA), potentially contributing to upper airway instability and impaired breathing during sleep. However, its precise role in determining disease severity remains unclear. This study aimed to evaluate the relationship between patients’ subjective perception of breathing patterns (nasal vs. oral) and OSA severity, as well as the impact of structural nasal abnormalities and their anatomical location. Methods: This cross-sectional study was conducted at the University Hospital Center Osijek, Croatia, between May 2024 and September 2025. Sixty adult patients with diagnosed moderate-to-severe OSA (apnoea–hypopnoea index [AHI] ≥ 15 events/hour) were included. All participants underwent polysomnography and otorhinolaryngological evaluation, including anterior rhinoscopy and nasal endoscopy. Structural abnormalities assessed included septal deviation and inferior turbinate hypertrophy, classified according to a modified Cottle system. Statistical analyses were performed using non-parametric tests and correlation methods, with significance set at p < 0.05. Results: The study included 60 patients (median age 56 years; 71.7% male), of whom 23% had moderate and 77% severe OSA (median AHI 39.4). No significant association was found between subjective breathing pattern and OSA severity (p = 0.8), although patients with predominantly oral breathing exhibited higher median AHI values. Oral breathing was significantly associated with the presence of septal deviation (p < 0.001) and inferior turbinate hypertrophy (p < 0.001). Structural deformities in oral breathers were most frequently localized in the nasal valve region (Area II) (p < 0.001). However, neither the presence nor the anatomical location of nasal deformities showed a significant relationship with AHI values (p = 0.93). Conclusions: Subjective breathing pattern was not significantly associated with OSA severity, although oral breathing tended to be linked with higher AHI values. Structural nasal abnormalities were significantly more prevalent among oral breathers but did not influence disease severity. These findings suggest that nasal obstruction plays a limited role in determining OSA severity, while remaining clinically relevant as a potentially modifiable factor influencing breathing patterns and treatment adherence. Further research is warranted to evaluate the impact of interventions targeting nasal breathing in the comprehensive management of OSA.