Prevalence of Upper Airway Tumors and Cysts among Patients Who Snore

Suzuki, Masuko; Saigusa, Hanako; Chiba, Shintaro; Hoshino, Tetsuya; Okamoto, Makito

doi:10.1177/000348940711601109

Cited by 6 publications

(4 citation statements)

References 14 publications

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“…OSA can induce significant morbidity and mortality, and has been associated with severe daytime hypersomnolence and cardiovascular complications, including systemic hypertension, cardiac arrhythmias, and automobile accidents (33,34). Among patients complaining of snoring, 2.4 in 1,000 were found to have upper airway tumors, or cysts such as nasopharyngeal cancer in a multicenter research (5). Further, OSA with cancer in the upper airway has been reported to occur in 76% (13 of 17) of patients with cancer in the oral cavity and oropharynx, and in 72% (13 of 18) of patients with nasopharyngeal cancer.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of radiotherapy for head and neck cancer on obstructive sleep apnea: a prospective study

Inoshita¹,

Sata²,

Ohba³

et al. 2022

Ann Palliat Med

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Background: In recent years, a relatively high prevalence of obstructive sleep apnea (OSA) in patients following radiotherapy (RT) for head and neck cancer (HNC) has been reported; however, little is known regarding the impact of RT on sleep disorders and the underlying mechanisms. This aim of this study was to elucidate the pathogenesis of OSA by comparing the clinical and sleep test parameters and magnetic resonance imaging (MRI) findings before and after HNC treatment with radiation.Methods: This prospective study included patients scheduled for RT with or without chemotherapy or bioradiotherapy for HNC. Patients diagnosed with HNC between May 2017 and August 2020 were consecutively recruited. The results of the sleep tests were analyzed both before and after treatment. The clinical characteristics of the patients and cephalometric and MRI parameters were also measured.Results: First, a total of 32 patients (64.8±11.8 years old; BMI, 22.7±3.6 kg/m 2 ) underwent pre-treatment sleep tests. The prevalence of OSA [apnea hypopnea index (AHI) ≥5] in these patients was 81.3% (26 patients) before treatment, and the mean AHI was 20.8±19.0 events/hr. Next, 21 patients performed a sleep test both before and after treatment. Regarding subjective symptoms, there were no significant differences in the Epworth Sleepiness Scale (ESS) (P=0.142) or Pittsburgh Sleep Quality Index (PSQI) (P=0.935) after treatment; however, the BMI and neck circumference significantly decreased after treatment (P<0.0001 and P=0.0001, respectively). The incidence of OSA in these patients was 81.0% (17 patients) before treatment and 85.7% (19 patients) after treatment (P=1.0). Overall, the AHI was not significantly different, changing only from 14.5 to 14.9 after treatment (P=0.147). The MRI parameters showed that the retroglossal pharyngeal area increased significantly after treatment (P=0.007).Conclusions: This study found that the prevalence of OSA before and after RT for HNC was higher than that in the normal population, despite a significant decrease in BMI and increase in the retroglossal pharyngeal area after treatment. We suggest that physicians who manage patients with HNC should consider the occurrence of OSA before and after treatment.

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Section: Discussionmentioning

confidence: 99%

“…The prevalence of upper airway tumors and cysts among patients complaining of snoring was 0.24% in a multi-center study (5). The prevalence of OSA with head and neck cancer (HNC) in the upper airway was reported to be 76% in oral cavity, oropharyngeal cancer and 72% in nasopharyngeal cancer (6,7).…”

Section: Introductionmentioning

confidence: 99%

Impact of radiotherapy for head and neck cancer on obstructive sleep apnea: a prospective study

Inoshita¹,

Sata²,

Ohba³

et al. 2022

Ann Palliat Med

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“…Furthermore, according to a previous report, a tumor or cystic disease causes complications in the upper respiratory tract in 0.24% of SAS patients. 8 As a clinical condition of hypertension accompanying sleep apnea, sympathetic nerve stimulation due to hypoxemia is considered to be related, 9 but no abnormality was observed in the preoperative serum hormone concentration (E and EN). However, since blood pressure decreased postoperatively, a cystectomy was performed for nCPAP function, and this is thought to have contributed to a decrease in blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Intra-Adenoid Cyst: A Case Report with an Immunohistochemical Study and Review of Literature

Matsumoto

Yokoi

Ikeda

et al. 2015

Clin Med Insights Case Rep

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A woman in her 50s was referred to our department with the chief complaint of nasal congestion and pharyngeal discomfort. The patient had been diagnosed with sleep apnea at the Department of Internal Medicine, and had undergone nasal continuous positive airway pressure (nCPAP) therapy, but her response to the treatment was poor. A cystic lesion occupying the nasopharynx, which was detected by nasopharyngeal fiberscopy, computed tomography, and magnetic resonance imaging, was thought to be the cause of the nasal congestion, pharyngeal discomfort, and obstructive sleep apnea syndrome (OSAS). Consequently, the patient underwent extirpation of the lesion under general anesthesia for the purpose of obtaining a definitive diagnosis as well as for treatment of the nasopharyngeal tumor. The diagnosis of intra-adenoid cyst was eventually made based on the pathological findings, which revealed lymphoid tissue accompanied by expansion of the crypt, as well as inflammatory cell infiltration with follicular hyperplasia. After the operation, the patient reported subjective improvement of her symptoms, and began to respond to the nCPAP therapy for her sleep apnea syndrome. Nasopharyngeal cysts, in particular adult intra-adenoid cyst, are relatively rare. The outcomes of the current case indicated that the presence of a nasopharyngeal cystic disease was hampering the nCPAP treatment of refractory OSAS.

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“…Some patients may present with sleep disturbance and a recent multicenter trial suggested that 2.4 per 1000 patients who snore have an upper airway tumor or cyst. 7 A history of waking up at night in panic with breathing difficulties may suggest a critical obstruction. 8 Dyspnea and stridor due to airway obstruction occur with advanced disease.…”

Section: Airway Assessmentmentioning

confidence: 99%

Special Considerations in Anesthesia for Laryngeal Cancer Surgery

Flory

Appadurai²

2010

An International Journal of Otorhinolaryngology Clinics

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The airway is not only shared but operated upon during laryngeal cancer surgery. Patients with laryngeal cancer may require general anesthesia for diagnostic endoscopic procedures, for endolaryngeal laser surgery or for major cancer resectional surgery. This review outlines the importance of careful assessment of the airway and medical comorbidities and discusses the options for anesthetic and ventilatory management whilst ensuring a safe airway, adequate oxygenation and the best possible view of the surgical field. Laryngeal cancer surgery may improve the airway or create new problems and the need for meticulous planning, multidisciplinary input, good communication and close cooperation between all members of the team is emphasized.

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Prevalence of Upper Airway Tumors and Cysts among Patients Who Snore

Abstract: Routine detailed nasopharyngeal endoscopy should be carried out in each institution so as not to overlook organic diseases in the upper airway among patients who snore.

Cited by 6 publications

References 14 publications

Impact of radiotherapy for head and neck cancer on obstructive sleep apnea: a prospective study

Impact of radiotherapy for head and neck cancer on obstructive sleep apnea: a prospective study

Intra-Adenoid Cyst: A Case Report with an Immunohistochemical Study and Review of Literature

Special Considerations in Anesthesia for Laryngeal Cancer Surgery

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