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[Sleep apnea syndrome after total laryngectomy]
1Centre du Sommeil, Service de Neurophysiologie Clinique, CHU Timone, Marseille, France. francois.philip-joet@mail.ap-hm.fr
Revue Des Maladies Respiratoires
|November 13, 2004
Summary
Severe sleep apnea syndrome after total laryngectomy is rare but treatable. A silver tracheostomy tube can resolve symptoms by preventing airway collapse during sleep.
Area of Science:
- Otolaryngology
- Sleep Medicine
- Respiratory Medicine
Background:
- Sleep apnea syndrome was historically treated with tracheostomy before the advent of nasal continuous positive airway pressure.
- Sleep apnea syndrome occurring after total laryngectomy is an uncommon clinical presentation.
Observation:
- A 73-year-old male, post-total laryngectomy for cancer, presented with severe sleep apnea syndrome confirmed by polysomnography (apnea-hypopnea index of 89).
- Examination revealed significant reduction in tracheostomy orifice diameter during supine positioning, attributed to negative airway pressure and hypotonia during sleep.
Findings:
- The insertion of a silver tracheostomy cannula effectively reversed the sleep apnea syndrome symptoms.
- The apnea-hypopnea index normalized after the use of the silver tracheostomy tube.
Implications:
- This case highlights that tracheostomy wall collapse during sleep can cause sleep apnea syndrome post-laryngectomy.
- A silver tracheostomy tube offers a viable treatment option for this specific complication, improving patient outcomes.