Spontaneous retropharyngeal haematoma with direct oral anticoagulant medication

2021 ◽  
Vol 14 (5) ◽  
pp. e240369
Author(s):  
Munir Abukhder ◽  
Jonathan Hulme ◽  
Shakira Nathoo ◽  
Shubhi Shubhi
Keyword(s):  
Sleep Apnoea ◽  
Good Recovery ◽  
Anterior Aspect ◽  
Obstructive Sleep ◽  
Soft Tissue Swelling ◽  
Prevertebral Soft Tissue ◽  
History Of ◽  
Anticoagulant Medication ◽  
Previous Medical History ◽  
Prevertebral Soft Tissue Swelling

A 79-year-old man presented to the emergency department following a 1-week history of dyspnoea, dysphonia, dysphagia and a nonproductive cough. Previous medical history included atrial fibrillation, for which he was taking rivaroxaban, hypertension and obstructive sleep apnoea. On assessment, there was a mild stridor, swelling of the anterior aspect of the neck and submandibular bruising. CT of the neck demonstrated prevertebral soft tissue swelling extending from C1 to C6 levels, approximately 88 mm in length with a maximum depth of 25 mm. A diagnosis of spontaneous retropharyngeal haematoma was made: the airway was secured with fibreoptic nasal intubation and the patient admitted to the intensive care unit. Direct and fibreoptic assessment of the airway on day 3 confirmed that the haematoma had significantly reduced in size. The patient was extubated on day 4 and made a good recovery.

scholarly journals Self-reported sleepiness and not the apnoea hypopnoea index is the best predictor of sleepiness-related accidents in obstructive sleep apnoea

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
P. Philip ◽  
S. Bailly ◽  
M. Benmerad ◽  
J. A. Micoulaud-Franchi ◽  
Y. Grillet ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Traffic Accidents ◽  
Sleep Apnoea ◽  
Near Miss ◽  
Cross Sectional ◽  
Periodic Leg Movements ◽  
Obstructive Sleep ◽  
History Of ◽  
Respiratory Polygraphy ◽  
Sectional Analysis

Abstract To evaluate the value of apnoea + hypopnoea index versus self-reported sleepiness at the wheel in anticipating the risk of sleepiness-related accidents in patients referred for obstructive sleep apnoea. A cross-sectional analysis of the French national obstructive sleep apnoea registry. 58,815 subjects referred for a suspicion of obstructive sleep apnoea were investigated by specific items addressing sleepiness at the wheel and sleepiness-related accidents. Apnoea + hypopnoea index was evaluated with a respiratory polygraphy or full polysomnography. Subjects had a median age of 55.6 years [45.3; 64.6], 65% were men, with a median apnoea + hypopnoea index of 22 [8; 39] events/h. Median Epworth sleepiness scale score was 9 [6; 13], 35% of the patients reported sleepiness at the wheel (n = 20,310), 8% (n = 4,588) reported a near-miss accident and 2% (n = 1,313) reported a sleepiness-related accident. Patients reporting sleepiness at the wheel whatever their obstructive sleep apnoea status and severity exhibited a tenfold higher risk of sleepiness-related accidents. In multivariate analysis, other predictors for sleepiness-related accidents were: male gender, ESS, history of previous near-miss accidents, restless leg syndrome/periodic leg movements, complaints of memory dysfunction and nocturnal sweating. Sleep apnoea per se was not an independent contributor. Self-reported sleepiness at the wheel is a better predictor of sleepiness-related traffic accidents than apnoea + hypopnoea index.

28. Prevertebral soft tissue swelling after ACDF

2004 ◽  
Vol 4 (5) ◽  
pp. S17
Author(s):  
Kyung-Soo Suk ◽  
Ki-Tack Kim ◽  
Sung-Chul Bae
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Swelling ◽  
Prevertebral Soft Tissue ◽  
Prevertebral Soft Tissue Swelling

scholarly journals P061 The effect of anxiety on symptom burden in patients with obstructive sleep apnoea

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A41-A41
Author(s):  
L Kelley ◽  
G Hamilton
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Functional Outcomes ◽  
Depression Scale ◽  
Symptom Burden ◽  
Severity Index ◽  
Sleep Apnoea ◽  
Common Symptom ◽  
Fatigue Score ◽  
Obstructive Sleep ◽  
History Of

Abstract Background There is a high prevalence of anxiety in patients with obstructive sleep apnoea and such patients often describe fatigue in addition to sleepiness. We currently use the Epworth Sleepiness Scale (ESS) to quantify sleepiness in our patients, but we do not have useful tools for assessing fatigue. Fatigue is a common symptom in patients with many medical conditions but has not been well studied in patients presenting to sleep services. Our hypothesis is that patients with obstructive sleep apnoea who have a comorbid anxiety disorder, as measured by the Hospital Anxiety and Depression Scale (HADS) are likely to have increased symptom burden such as fatigue or poorer functional outcomes of sleep. Methods Analysis of prospectively collected data from 128 adult patients referred for suspected obstructive sleep apnea to Monash University Health Sleep Clinic. All patients have completed a comprehensive questionnaire prior to their first clinical review assessing their symptom burden at baseline. Questionnaires completed include extensive symptom and medical history assessment, the Fatigue Severity Scale (FSS), ESS, HADS, Functional Outcomes of Sleep Questionnaire (FOSQ), Insomnia Severity Index (ISI) and Global Fatigue Score. All patients were subsequently reviewed by a clinician and have overnight polysomnography data available. Progress to date; Data collected for all 128 participants. Preliminary analysis currently underway. Intended outcome & impact; We intend to examine whether the comorbidity of anxiety results in an increased or different symptom burden in patients referred for suspected obstructive sleep apnoea when compared to patients without a history of anxiety.

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