Related Experiment Video
Updated: May 17, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Upper airway study should always come before any sleep study in OSAS evaluation: a giant parapharyngeal lipoma behind
M Casale1, F Salvinelli, C A Mallio
1Campus Bio-Medico University, School of Medicine, Rome, Italy. m.casale@unicampus.it
Background:
The parapharyngeal space (PPS) is a rare site for neoplasms in the head and neck and lipoma represents 0.5% of all head and neck tumors.
Case Report:
We describe a case of a giant parapharyngeal lipoma in obese adult patient causing anatomic pharyngeal obstruction with severe obstructive sleep apnea (OSA) syndrome. The patient was successfully operated with transcervical approach.
Conclusions:
In patients presenting with symptoms suggestive of OSA, it is essential to rule out any physical cause and perform a comprehensive ear, nose and throat examination including fibro-endoscopic upper airway examination before referral for sleep study and management. The ideal management for OSA involves treating the underlying cause. If no definitive cause is identified, management should begin with conservative measures such as lifestyle changes and a weight loss program; if these are unsuccessful, continuous positive airway pressure (CPAP), oral appliances or upper airway surgery could be considered. Better diagnostic methods should be developed to identify the main OSA causes and improve therapeutic outcomes.
Related Concept Videos
Sleep Apnea
The condition is more prevalent among...
Cardiopulmonary Resuscitation II: ACLS Airway Management
Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Suctioning the Oropharyngeal Airway
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
Suctioning the Nasopharyngeal Airway
Equipment Required

