Neurofibromatosis of the larynx causing stridor and sleep apnea

Setabutr, Dhave; Perez, Myrza R.; Truong, Mai Thy; Senders, Craig W; Rubinstein, Brian

doi:10.1016/j.amjoto.2014.04.009

Cited by 16 publications

(17 citation statements)

References 24 publications

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“…48,61 Additionally, there are cases of laryngeal lesions causing obstructive sleep apnea in neurofibromatosis. 68 Tracheostomy is employed if other surgical interventions are inadequate, severe neurologic comorbidities are present, or the airway is obstructed when the patient is awake. This bypasses the entire upper airway, definitively correcting obstructive sleep apnea.…”

Section: Surgery For Laryngomalaciamentioning

confidence: 99%

Surgical management of sleep-disordered breathing in children

Qualls

Rimell

2015

Operative Techniques in Otolaryngology-Head and Neck Surgery

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Section: Surgery For Laryngomalaciamentioning

confidence: 99%

Surgical management of sleep-disordered breathing in children

Qualls

Rimell

2015

Operative Techniques in Otolaryngology-Head and Neck Surgery

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“…Previous treatment patients had undertaken before diagnosis of the causative neoplasm was reported in 26 patients, with 22 patients using CPAP devices and two using bilevel positive airway pressure (BiPAP) devices. Three patients had undergone sleep surgery procedures – one each of adenotonsillectomy, 11 septoplasty 12 and tracheostomy 13…”

Section: Resultsmentioning

confidence: 99%

“…The majority of included patients had their neoplasms treated surgically, with 57 patients (72.2%) treated with surgery alone 9–12,14–61 . Two patients (2.5%) were treated with both surgery and radiotherapy, 13,62 and one patient (1.3%) treated with each of surgery and chemotherapy 63 and surgery and chemoradiotherapy 64 .…”

Section: Resultsmentioning

confidence: 99%

Scoping review of head and neck neoplasms presenting with obstructive sleep apnoea: the importance of flexible nasendoscopy

Moore

Cardemil

Hayward

et al. 2020

ANZ Journal of Surgery

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Background Obstructive sleep apnoea (OSA) can be caused by neoplasms involving the upper aerodigestive tract. Currently, many of these patients have this diagnosis missed, as most adults diagnosed with OSA do not undergo adequate head and neck examination including flexible nasendoscopy. We performed a review of the literature to shed light on this phenomenon and outline the pathologies and issues surrounding this sub‐population of patients diagnosed with OSA. Methods A scoping review of the literature was conducted on head and neck neoplasms presenting with OSA. Data were extracted on demographics, clinical presentation, histopathology, treatment and patient outcomes. Results Sixty‐seven articles were included, describing 79 patients. Mean age was 45.8 years, and 77.2% were male. Symptoms of OSA were present for an average of 29.2 months before a diagnosis of causative neoplasm was made. Forty‐two different benign and malignant histopathological entities were reported. At diagnosis, the causative pathology of 100% of patients was visible on head and neck examination including flexible nasendoscopy, while only 53.2% were visible on trans‐oral examination. One‐third of patients had commenced inappropriate treatment for OSA, including three who had undergone sleep surgical procedures. The majority of patients were treated with surgery alone (72.2%). Conclusion Although rare, neoplasms of the upper aerodigestive tract should be considered as a cause of OSA, especially in patients experiencing other symptoms in addition to the typical symptoms of OSA. They should particularly be considered in patients with comparatively lower body mass index or those with worsening OSA without an apparent cause identified.

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“…7 In another reported case of a 2-year-old boy who developed sleep apnea associated with what was initially believed to be a solitary laryngeal neurofibroma, additional examination revealed café-au-lait spots, marking the importance of a thorough physical examination in all patients who develop neurofibromas of any type or location. 9 The diagnostic criteria for NF1, developed at the National Institutes of Health Consensus Development Conference of 1988, requires at least 2 characteristic symptoms for diagnosis, including 1 plexiform neurofibroma or ≥2 nonplexiform neurofibromas, in combination with other cutaneous findings. 8 In the case of our 16-year-old patient, the late age of onset of her nonplexiform laryngeal neurofibroma as her only presenting feature of neurofibromatosis is not a sufficient criterion to diagnose her with NF1.…”

Section: Discussionmentioning

confidence: 99%

A solitary supraglottic neurofibroma presenting with obstructive sleep apnea in an adolescent

Hutnik

Chen

Mortensen

2020

Journal of Clinical Sleep Medicine

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Obstructive sleep apnea (OSA) is commonly encountered in the pediatric population and has a large differential diagnosis. As clinicians, we must determine who needs to undergo flexible laryngoscopy to rule out potential obstructing lesions causing OSA. This report presents a 16-year-old female who presented with snoring, "asthma," dysphagia, and OSA. Flexible laryngoscopy and computed tomography revealed a neurofibroma of the aryepiglottic fold without associated neurofibromatosis type 1. The patient underwent microlaryngoscopy and the lesion was excised using cold steel and a carbon dioxide laser. At 6 months' followup, the patient was breathing without difficulty and had no evidence of recurrence. Solitary laryngeal neurofibromas are extremely rare, and this is the first case of an adolescent with OSA caused by a solitary supraglottic neurofibroma. A supraglottic mass needs to be considered in the differential diagnosis of patients with OSA who fail conservative treatment, even a diagnosis as rare as a solitary laryngeal neurofibroma.

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Neurofibromatosis of the larynx causing stridor and sleep apnea

Cited by 16 publications

References 24 publications

Surgical management of sleep-disordered breathing in children

Surgical management of sleep-disordered breathing in children

Scoping review of head and neck neoplasms presenting with obstructive sleep apnoea: the importance of flexible nasendoscopy

A solitary supraglottic neurofibroma presenting with obstructive sleep apnea in an adolescent

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