Obstructive Sleep Apnea After Supracricoid Laryngeal Surgery (OPHL II): A Monocentric Prospective Pilot Study

Area of Science:

• Otolaryngology
• Sleep Medicine
• Radiology

Background:

• Obstructive sleep apnea (OSA) is increasingly prevalent in patients undergoing supracricoid laryngeal surgery.
• Postoperative anatomical changes affecting sleep-disordered breathing are not well understood.
• This study investigates OSA incidence and severity following Open Partial Horizontal Laryngectomy type II (OPHL II).

Purpose of the Study:

• To assess the incidence and severity of OSA after OPHL II.
• To correlate polysomnographic parameters with radiologic measurements of the neolarynx.
• To identify potential predictors of postoperative OSA.

Main Methods:

• Prospective observational cohort study of 10 patients at least one year post-OPHL II.
• Patients completed OSA screening questionnaires (Stop-Bang, Berlin, Epworth) and underwent polysomnography.
• Cervical CT scans measured airway dimensions: ALVC, SVTH, SVTV, and BTCB.

Main Results:

• OSA was detected in all participants (40% mild, 30% moderate, 30% severe).
• Mean Apnea-Hypopnea Index (AHI) was 25.5 ± 18.9 events/h, correlating strongly with OSA severity.
• Supralaryngeal vertical tract (SVTV) positively correlated with OSA severity (rho=0.82), while base-of-tongue-to-cervical-body distance (BTCB) negatively correlated (rho=-0.71).

Conclusions:

• Supracricoid laryngectomy leads to anatomical alterations predisposing patients to OSA.
• Radiologic metrics, specifically SVTV and BTCB, show promise as predictors of OSA severity.
• Multidisciplinary care is crucial for timely OSA diagnosis and management; larger studies are needed.