[Obstructive sleep apnea in older patients after the closure of a tracheostoma]

The closure of tracheostomies may postoperatively induce an obstructive sleep apnea (OSA) even in patients who never complained about sleep related breathing disorders before they underwent tracheotomy. The present study was designed to evaluate, whether OSA appears after the tracheostomy has been airtightly blocked and if so, whether there are typically illnesses predictive for OSA after operative closure of tracheostomies.

Twelve consecutive patients (3 male; 9 female; mean age 66 years), who addressed our clinic for operative closure of their tracheostomies were enrolled in this study over a period of 18 months. On basis of patient's history and clinical findings the patients were divided into two groups. Group A included 7 patients with laryngeal pathologies and group B included 5 patients with normal larynges. All patients underwent a 12-channel polysomnography (PSG) with airtightly blocked tracheostomies preoperatively.

In 5 patients a mild OSA and in one patient a severe OSA was diagnosed by PSG. The patients of group A with laryngeal pathologies were older, had a lower Body Mass Index (BMI) and a higher Apnea-Hypopnea Index than patients of group B (p < 0.05).

Laryngeal pathologies in the elderly might facilitate the development of OSA after operative closure of tracheostomies. Based on the results postoperative reevaluation is recommended for all elderly patients with laryngeal abnormalities after operative closure of the tracheostomy.