Giulia Anna Marciante*, Federico Leone, Alessandro Bianchi, Chiara Re and Fabrizio Salamanca

Unit of Otorhinolaryngology, Head and Neck Surgery, Humanitas San Pio X, Milan, Italy

*Corresponding Author: Giulia Anna Marciante, Unit of Otorhinolaryngology, Head and Neck Surgery, Humanitas San Pio X, Milan, Italy.

Received: April 04, 2022; Published: April 19, 2022

Abstract

The introduction of sleep endoscopy in the diagnosis of sleep apnea-hypopnea syndrome (OSAHS) has led to the development of a customization in the surgical approach of patients refusing nocturnal ventilation. Sometimes follow up polysomnography can show a recurrence of OSAHS, even in patients with no changes in weight or head and neck anatomy. We report a case of a patient undergone uvulopalatopharyngoplasty and epiglottoplasty showing a worsening of OSAHS years after surgery.

A 69-year-old man with moderate OSAHS refusing overnight ventilation underwent sleep endoscopy showing collpase of palate, tongue base and epiglottis. Uvulopalatopharyngoplasty and epiglottoplasty were then perfomed in addiction to application of mandibular advancement device (MAD), with normalization of parameters, as shown by the following polysomnographies. Over time, symptomes started to recur, and the patient underwent a new polysomnpography showing increase of apnea-hypopnoea index (AHI). A second sleep endoscopy was therefore performed, pointing out the role of the collapse of the residual epiglottis in developing apneas. Epiglottis stiffening operation was consequently perfomed with resolution of symptoms and reduction of AHI.

Patients treated with surgery and MAD should always be monitored with follow up polysomnography. Worsening of symptoms should be evaluated by means of sleep endoscopy in order to identify and treat the new causes of obstruction.

Keywords: OSAHS; Mandibular Advancement Device; Epiglottoplasty; Sleep Endoscopy

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Citation

Citation: Giulia Anna Marciante., et al. “Recurrence of OSAHS in a Patient Previously Treated with MAD and Multilevel Surgery: The Role of Epiglottis".Acta Scientific Otolaryngology 4.5 (2022): 26-29.

Copyright

Copyright: © 2022 Giulia Anna Marciante., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.