title: Resolution of severe sleep-disordered breathing with a nasopharyngeal obturator in 2 cases of nasopharyngeal stenosis complicating uvulopalatopharyngoplasty.
abstract: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is characterized by episodic decrements in airflow due to upper airway obstruction. Uvulopalatopharyngoplasty (UPPP) is a potential therapy for OSAHS. Nasopharyngeal stenosis is a rare complication of UPPP that worsens OSAHS. We report two patients referred for OSAHS worsened by nasopharyngeal stenosis complicating UPPP. Both patients were treated with carbon dioxide laser release of adhesions and placement of a nasopharyngeal obturator. Follow-up polysomnograms demonstrated resolution of OSAHS correlating with subjective resolution of symptoms. Nasopharyngeal stenosis complicating UPPP can be successfully treated with scar removal and nasopharyngeal stenting. Polysomnographic demonstration of the effectiveness of this therapy has not previously been reported. Future questions include duration of nasopharyngeal stenting and timing of follow-up polysomnography.
authors.affiliation: Brooke Army Medical Center, Fort Sam Houston, Texas 78234, USA. alan.deangelo@amedd.army.mil
authors.forename: Alan
authors.initials: A
authors.lastname: DeAngelo
authors.forename: Vincent
authors.initials: V
authors.lastname: Mysliwiec
mesh_terms: D002245:Carbon Dioxide / Q000627:therapeutic use; D003251:Constriction, Pathologic / Q000150:complications* / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D009302:Nasopharyngeal Diseases / Q000150:complications* / Q000628:therapy*; D009305:Nasopharynx; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010160:Palate, Soft / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D017286:Polysomnography; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery; D020181:Sleep Apnea, Obstructive / Q000150:complications*; D014609:Uvula / Q000601:surgery*
chemical_list: D002245:Carbon Dioxide