scholarly journals Oropharyngeal rhabdomyoma: the cause of severe sleep apnoea?

2020 ◽  
Vol 13 (2) ◽  
pp. e230949
Author(s):  
Henrik Jonathan Münch ◽  
Padraig O'Leary ◽  
Jesper Bille ◽  
Thomas Kjaergaard
Keyword(s):  
Striated Muscle ◽  
Sleep Apnoea ◽  
Transoral Robotic Surgery ◽  
Elderly Male ◽  
First Case ◽  
Obstructive Sleep ◽  
Severe Reduction ◽  
Minor Degree ◽  
Benign Tumours

This case report presents an elderly male patient who on diagnosis with a large oropharyngeal tumour had no specific symptomatology apart from severe obstructive sleep apnoea. Histopathology revealed the tumour to be an adult rhabdomyoma, a rare but benign tumour arising from striated muscle cells. The tumour obstructed most of the oropharyngeal space and almost occluded the patient’s airway when lying in a supine position. The patient was deemed operable, and the tumour was excised in toto using a transoral robotic surgery system. On follow-up, the patient had a severe reduction of apnoeas/hypopnoeas and felt subjectively ‘reborn’. This is to our knowledge the first case where an adult rhabdomyoma is removed using a robot-assisted approach, thus presenting a new and viable option when considering removal of benign tumours of the pharynx leading to a very minor degree of morbidity for the patients.

Hyper-eosinophilic syndrome: An uncommon cause of chronic abdominal pain in an elderly male

2021 ◽  
pp. 004947552098776
Author(s):  
Dibya L Praharaj ◽  
Bipadabhanjan Mallick ◽  
Preetam Nath ◽  
Sarat C Panigrahi ◽  
Anil C Anand ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Wide Spectrum ◽  
Hypereosinophilic Syndrome ◽  
Connective Tissue Disorder ◽  
Sleep Apnoea ◽  
Chronic Abdominal Pain ◽  
Elderly Male ◽  
Essentially Normal ◽  
Organ Systems ◽  
Obstructive Sleep

Hypereosinophilia is defined as an absolute eosinophil count of ≥1.5 × 109/L, and its presence with involvement of at least one organ system defines the hypereosinophilic syndrome. It may occur with parasitic infestation, connective tissue disorder or rarely in clonal disorders such as eosinophilic leucaemia. Organ systems that may be involved include the cardiovascular, central nervous, respiratory and gastrointestinal systems. In the latter, a wide spectrum of clinical presentation may be seen from trivial, to debilitating or rarely fatal. We report an elderly male with a history of bronchial asthma, obstructive sleep apnoea and food allergy who presented with chronic abdominal pain and weight loss. Abdominal examination and routine evaluation were essentially normal other than a peripheral hyper-eosinophilia. We witnessed a brisk and lasting response to an elimination diet and corticosteroids.

Quality of life of children with sleep-disordered breathing treated with adenotonsillectomy

2010 ◽  
Vol 125 (2) ◽  
pp. 193-198 ◽  
Author(s):  
S M Powell ◽  
M Tremlett ◽  
D A Bosman
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnoea ◽  
Sleep Disordered Breathing ◽  
Sleep Apnoea ◽  
Life Assessment ◽  
Effect Sizes ◽  
Obstructive Sleep ◽  
Disordered Breathing

AbstractObjective:To assess the quality of life of UK children with sleep-disordered breathing undergoing adenotonsillectomy, by using the Obstructive Sleep Apnoea 18 questionnaire and determining score changes and effect sizes.Design:Prospective, longitudinal study.Setting:The otolaryngology department of a university teaching hospital in Northern England.Participants:Twenty-eight children for whom adenotonsillectomy was planned as treatment for sleep-disordered breathing, and who had either a clinical history consistent with obstructive sleep apnoea or a polysomnographic diagnosis.Main outcome measure:The Obstructive Sleep Apnoea 18 questionnaire, a previously validated, disease-specific quality of life assessment tool; changes in questionnaire scores and effect sizes were assessed.Methods:The Obstructive Sleep Apnoea 18 questionnaire was administered to each child's parent pre-operatively, then again at the follow-up appointment. Questionnaire scores ranged from 1 to 7. Score changes were analysed using the paired t-test; effect sizes were calculated using 95 per cent confidence intervals.Results:Complete data were obtained for 22 children (mean age, 61 months). Ten had undergone pre-operative polysomnography. Twenty-one children underwent adenotonsillectomy (one underwent tonsillectomy). Median follow up was eight weeks (interquartile range, six to 11 weeks). Following surgery, the overall mean score improvement was 2.6 (p < 0.0001) and the mean effect size 2.4 (95 per cent confidence interval 1.9 to 2.8). There were significant improvements in each of the individual questionnaire domains, i.e. sleep disturbance (mean score change 3.9, p < 0.0001), physical suffering (2.2, p < 0.0001), emotional distress (2.0, p = 0.0001), daytime problems (1.8, p = 0.0001) and caregiver concerns (2.6, p < 0.0001).Conclusion:In these children with sleep-disordered breathing treated by adenotonsillectomy, Obstructive Sleep Apnoea 18 questionnaire results indicated significantly improved mean score changes and effect sizes across all questionnaire domains, comparing pre- and post-operative data.

scholarly journals P094 CPAP Service Patient Experience Survey

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A51-A52
Author(s):  
R Mihai ◽  
K Ellis ◽  
N Verginis ◽  
M Davey ◽  
G Nixon
Keyword(s):  
Support Groups ◽  
Online Survey ◽  
Positive Airway Pressure ◽  
High Standard ◽  
Standard Of Care ◽  
Sleep Apnoea ◽  
Information Support ◽  
Obstructive Sleep ◽  
Experience Survey

Abstract Introduction Increasing numbers of children with obstructive sleep apnoea require continuous positive airway pressure (CPAP) treatment. We aimed to collect feedback from parents/carers about our CPAP education and follow-up programme. Methods An online survey link was texted to families of children starting outpatient CPAP from Jan 2019 -Feb 2021. Questions assessed satisfaction with the CPAP initiation process, including education by our nurse educator (NE), mask fitting, using equipment, accessing help, confidence using CPAP and follow up. Open-ended feedback was invited. Results 17/55 (31%) of eligible families responded. “Very satisfied” responses regarding CPAP education ranged from 76% (discussion of costs) to 94% (machine use and maintenance). All families felt confident starting CPAP at home. Two reported issues starting CPAP, but reported feeling fully supported by staff remotely to troubleshoot. All families were “somewhat” or “very satisfied” with NE follow-up, with 2 families more neutral about physician follow-up. Two families reported lower satisfaction (“somewhat dissatisfied” or neutral) with the range of paediatric masks, rather than with the mask fitting process itself. Of 14 general comments, 64% were positive (most common theme was high standard of care from the NE); 21% negative (lack of mask choices, location of consulting suites); and 15% neutral. Suggestions for improvement included financial support information, support groups and online consumable ordering. Discussion Families feel confident and well supported to commence outpatient CPAP, highlighting the care, knowledge and support provided by our team. Findings emphasize the importance of a dedicated NE. Suggestions provided will inform future service improvements.

Thyroglossal duct cysts and obstructive sleep apnoea: three case reports and review of the literature

2014 ◽  
Vol 128 (8) ◽  
pp. 738-741 ◽  
Author(s):  
F Safiruddin ◽  
D L Mourits ◽  
N de Vries
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Case Reports ◽  
Sleep Apnoea ◽  
Thyroglossal Duct Cyst ◽  
Duct Cyst ◽  
Thyroglossal Duct ◽  
First Case ◽  
Obstructive Sleep ◽  
Thyroglossal Duct Cysts

AbstractBackground:Thyroglossal duct cysts and obstructive sleep apnoea are commonly occurring medical conditions which appear to present independently in patients. However, we noted three cases where the thyroglossal duct cysts influenced the development and/or therapy of obstructive sleep apnoea. In this article, these three case studies are presented, as is a study of the association between thyroglossal duct cysts and obstructive sleep apnoea, preceded by a literature review.Case reports:The patient in the first case study underwent hyoidthyroidpexia for obstructive sleep apnoea, which revealed an unexpected thyroglossal duct cyst. The second patient had previously undergone Sistrunk surgery for the removal of a thyroglossal duct cyst and subsequently presented with obstructive sleep apnoea. Finally, the third patient, who had previously undergone Sistrunk surgery, presented with obstructive sleep apnoea and underwent alternative surgery as hyoidthyroidpexia was no longer possible.Conclusion:To our knowledge, the association between thyroglossal duct cysts and obstructive sleep apnoea has not been addressed previously. The results indicate that the relationship is much stronger than previously thought, and further research is required to investigate the extent of the association and possible causal relations.

scholarly journals Two months follow up of auto-CPAP treatment in patients with obstructive sleep apnoea

Thorax ◽  
1999 ◽  
Vol 54 (2) ◽  
pp. 147-149 ◽  
Author(s):  
A Boudewyns ◽  
V Grillier-Lanoir ◽  
M J Willemen ◽  
W A De Cock ◽  
P H Van de Heyning ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Cpap Treatment ◽  
Obstructive Sleep

scholarly journals Impact of surgical maxillomandibular advancement upon pharyngeal airway volume and the apnoea–hypopnoea index in the treatment of obstructive sleep apnoea: systematic review and meta-analysis

2019 ◽  
Vol 6 (1) ◽  
pp. e000402 ◽  
Author(s):  
Maria Giralt-Hernando ◽  
Adaia Valls-Ontañón ◽  
Raquel Guijarro-Martínez ◽  
Jorge Masià-Gridilla ◽  
Federico Hernández-Alfaro
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnoea ◽  
Meta Analysis ◽  
Sleep Apnoea ◽  
Eligibility Criteria ◽  
Pharyngeal Airway ◽  
Maxillomandibular Advancement ◽  
Subsequent Decrease ◽  
Obstructive Sleep

BackgroundA systematic review was carried out on the effect of surgical maxillomandibular advancement (MMA) on pharyngeal airway (PA) dimensions and the apnoea–hypopnoea index (AHI) in the treatment of obstructive sleep apnoea (OSA), with the aim of determining whether increased PA in the context of MMA is the main factor conditioning the subsequent decrease in AHI.MethodsA search was made of the PubMed, Embase, Google Scholar and Cochrane databases. A total of 496 studies were identified. The inclusion criteria were a diagnosis of moderate to severe OSA, MMA success evaluated by polysomnography, reporting of the magnitude of MMA achieved, PA increase and a minimum follow-up of 6 months.ResultsFollowing application of the eligibility criteria, eight articles were included. Metaregression analysis showed MMA to significantly increase both pharyngeal airway volume (PAV) (mean 7.35 cm3 (range 5.35–9.34)) and pharyngeal airway space (mean 4.75 mm (range 3.15–6.35)) and ensure a final AHI score below the threshold of 20 (mean 12.9 events/hour).ConclusionsAlthough subgroup analysis showed MMA to be effective in treating OSA, more randomised trials are needed to individualise the required magnitude and direction of surgical movements in each patient, and to standardise the measurements of linear and nonlinear PAV parameters.

Psychosis in Sleep Apnoea

1989 ◽  
Vol 23 (4) ◽  
pp. 571-573 ◽  
Author(s):  
Sing Lee ◽  
Helen F.K. Chiu ◽  
Char-Nie Chen
Keyword(s):  
Sleep Deprivation ◽  
Obstructive Sleep Apnoea ◽  
Complete Resolution ◽  
Slow Wave Sleep ◽  
Sleep Apnoea ◽  
Arterial Oxygen ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Intellectual Impairment ◽  
Obstructive Sleep

A 30-year-old man presenting with intellectual impairment and recurrent psychotic episodes was subsequently found to have suffered from a chronically untreated obstructive sleep apnoea syndrome. Polysomnography revealed sleep fragmentation, slow wave sleep deprivation and abnormal arterial oxygen desaturation. Tonsillectomy led to complete resolution of sleep apnoea and remission of psychosis at 2 years' follow-up, but his apparent intellectual impairment persisted. The limited literature on psychosis associated with sleep apnoea is briefly reviewed.

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