Micrognathia, obstructive sleep apnoea and cor pulmonale--a case for tracheostomy.
A patient with congenital micrognathia, hypersomnia and severe pulmonary hypertension which resulted in sudden death during sleep is described. Hypersomnolence is a well-recognized manifestation of the pickwickian syndrome. A less recognized but similar disorder may affect patients with congenital or acquired micrognathia. The pathogenesis of this syndrome and obstructive sleep apnoea are reviewed. Tracheostomy timeously performed may be life-saving and the value of early resort to this apparently drastic procedure in a high-risk patient is emphasized.
D000293:Adolescent; D005260:Female; D006801:Humans; D008844:Micrognathism / Q000150:complications*; D011660:Pulmonary Heart Disease / Q000209:etiology*; D012891:Sleep Apnea Syndromes / Q000209:etiology* / Q000517:prevention & control; D014140:Tracheotomy