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Obstructive sleep apnea caused by bilateral vocal fold paralysis.
1Department of Otorhinolaryngology-Head and Neck Surgery, Sahlgrenska University Hospital, S-431 45, Göteborg, Sweden. luaay.aziz@orlforum.com
Ear, Nose, & Throat Journal
|May 9, 2003
Summary
Severe obstructive sleep apnea (OSA) in a woman was successfully treated with vocal fold laterofixation. Surgery resolved OSA, with good long-term outcomes after a repeat procedure for symptom recurrence.
Area of Science:
- Otolaryngology
- Sleep Medicine
- Neurology
Background:
- Obstructive sleep apnea (OSA) significantly impacts patient health and quality of life.
- Bilateral vocal fold paralysis is a rare condition that can affect breathing and voice.
- The interplay between OSA and vocal fold paralysis requires careful diagnosis and management.
Observation:
- A patient presented with severe OSA, characterized by an apnea/hypopnea index of 120 and minimum oxygen saturation of 63%.
- Undiagnosed bilateral vocal fold paralysis was identified as a co-existing condition.
- Initial laterofixation of the right vocal fold led to immediate resolution of OSA.
Findings:
- Nocturnal polysomnography confirmed the resolution of OSA and normalized oxygen saturation levels post-surgery.
- A recurrence of snoring and daytime fatigue 4 years later prompted a repeat laterofixation.
- Both subjective and objective assessments indicated positive outcomes after the repeat surgical intervention.
Implications:
- Vocal fold laterofixation is an effective treatment for OSA secondary to vocal fold paralysis.
- Long-term follow-up is crucial for monitoring OSA and related symptoms after surgical intervention.
- This case highlights the importance of considering laryngeal pathology in patients with refractory OSA.