Microscopic bilateral posterior cordotomy in severe obstructive sleep apnea syndrome with bilateral vocal cord paralysis


Sariman N., Koca Ö., Boyaci Z., Levent E., Soylu A. C., Alparslan S., ...Daha Fazla

Sleep and Breathing, cilt.16, sa.1, ss.17-22, 2012 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 16 Sayı: 1
  • Basım Tarihi: 2012
  • Doi Numarası: 10.1007/s11325-010-0458-9
  • Dergi Adı: Sleep and Breathing
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.17-22
  • Anahtar Kelimeler: Bilateral vocal cord paralysis, Cordotomy, Microscopic suspension laryngoscopy, Obstructive sleep apnea syndrome, Vocal cord paralysis
  • Maltepe Üniversitesi Adresli: Evet

Özet

Background: Vocal cord paralysis is a rare cause of obstructive sleep apnea syndrome (OSAS). Recurrent laryngeal nerve injury after thyroid gland surgery is one of the leading causes of acquired vocal cord paralysis. Report: A 46-year-old woman with OSAS due to bilateral abductor vocal cord paralysis was presented. She had thyroidectomy 30 years ago and had a weak, breathy voice. She had been referred with a history of high-pitched snoring, apnea witnessed by her spouse, and excessive daytime sleepiness for the last 5 years. Full-night polysomnography revealed that her apnea - hypopnea index was 72/h and minimal oxygen saturation level was 81%. There was no REM and deep sleep periods. Ear - nose - throat consultation offered an endoscopic bilateral posterior cordotomy operation via microscopic suspension laryngoscopy (MLS) as a treatment option. Conclusions: Instead of using a nasal positive airway pressure (nCPAP) device, she was treated surgically. Her OSAS resolved completely within 5 months of the surgery. Her phonation was preserved, and symptoms such as snoring and hypersomnolance disappeared. In OSAS patients with bilateral vocal cord paralysis, MLS-associated bilateral posterior cordotomy can be a choice of treatment as an alternative to nCPAP application. © Springer-Verlag 2010.