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The epiglottis and obstructive sleep apnoea syndrome

Published online by Cambridge University Press:  29 June 2007

Frank J. Catalfumo ,
Avishay Golz ,
S. Thomas Westerman ,
Liane M. Gilbert ,
Henry Z. Joachims  and
David Goldenberg
Frank J. Catalfumo
Affiliation:
Head and Neck Laser Surgery Center of NJ, Brick, NJ, USA
Avishay Golz*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Rambam Medical Center, Technion – Israel Institute of Technology, Haifa, Israel
S. Thomas Westerman
Affiliation:
Medical College of Pennsylvania and Hahnemann University, Philadelphia, PA, USA
Liane M. Gilbert
Affiliation:
Westerman Research Associates, Inc., Shrewsbury, NJ, USA.
Henry Z. Joachims
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Rambam Medical Center, Technion – Israel Institute of Technology, Haifa, Israel
David Goldenberg
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Rambam Medical Center, Technion – Israel Institute of Technology, Haifa, Israel
*
Address for correspondence: Avishay Golz, M.D., Dept. of Otolaryngology–Head and Neck Surgery, Rambam Medical Center, P.O.B. 9602, Haifa 31092, Israel Fax: 972-4-851-5710, 972-4-854-2772 E-mail: golz@netvision.net.il
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Abstract

Obstructive sleep apnoea syndrome (OSAS) is caused by obstruction or narrowing of the airway at various levels. The repair of one site only will not alleviate the syndrome if there are obstructions in other sites. Epiglottis prolapse during inspiration is an unusual cause of airway obstruction and a rare cause of OSA.

Twelve cases of OSAS due to an abnormal epiglottis are presented. We present our approach to the diagnosis using fibre-optic examination of the hypopharynx, and our treatment using endoscopic carbon dioxide laser partial epiglottidectomy.

We found in our series that in 11.5 per cent of patients who failed the uvulopalatopharyngoplasty procedure, the reason was a narrow airway at the hypopharyngeal level caused by an abnormal epiglottis. It is our suggestion that in these cases a laser partial epiglottidectomy should be performed. The results of this study show that partial epiglottidectomy can increase the cure rate of patients with obstructive sleep apnoea syndrome by 10–15 per cent.

Keywords

Sleep apnoea syndromesEpiglottisLaser surgery
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 112 , Issue 10 , October 1998 , pp. 940 - 943
Copyright
Copyright © JLO (1984) Limited 1998

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Footnotes

Presented at the Annual Meeting of the American Academy of Otolaryngology – Head and Neck Surgery, San Diego, California, 18-21 September 1994.

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