Meet Dr Peter Baptisa and Dr. Mahran Altron some of our brilliant ENT specialists at Al Zahra Hospital Dubai, who recently contributed to an insightful case report on unique pathologies in Obstructive Sleep Apnea. Discover how innovative research and expertise are uncovering new dimensions in diagnosing and treating sleep apnea. Proud to have such dedicated professionals on our team!
Obstructive sleep apnea (OSA) is often associated with reduced pharyngeal muscle tone and an anatomically narrowed pharyngeal airspace. We try to describe two cases with OSA that were diagnosed with vascular lesions during DISE: One of them was an aberrant internal carotid artery, and the second one was a glomus tumor. These anatomic anomalies contribute to airspace narrowing in these patients. These two cases describe an exciting presentation of sleep apnea and remind us of the importance of clinically recognizing vascular alterations to avoid damage during routine oropharyngeal procedures.
OSA is a frequent disease associated with airway collapse. Many factors might produce the collapse of the airway, and they are usually centered in soft tissue, like fat deposition or muscle impairment. However, we must keep in mind that structures related to vascular lesions may also produce obstruction and have an essential role when surgery is indicated.
Currently, DISE (Drug-Induced sleep endoscopy) is a crucial tool to evaluate the site and type of airway collapse in patients suffering from OSA, especially in patients not tolerating the CPAP (continuous positive airway pressure).
The importance of DISE is shown not only for the regular recognition of the area of obstruction but also for diagnosing vascular changes that predispose to airway collapse and might have a significant role in treatment.
We present two unique cases in which DISE impacted the patient́s OSA treatment decision. Vascular head and neck alterations are infrequently encountered.
The internal carotid artery (ICA) usually follows a straight path from the bifurcation of the common carotid artery to the skull base. An aberrant ICA is susceptible to devastating injury during routine ENT procedures such as tonsillectomy and drainage of peritonsillar abscesses.
Glomus tumors are rare neoplasms derived from the paraganglion cells of the autonomic nervous system.They occur in various locations throughout the body, and their presence in the upper airway, particularly in the context of OSA, is an uncommon finding.
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