title: Role of thyroid surgery in the obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  To study the impact of thyroid surgery on obstructive sleep apnea syndrome (OSAS) evaluated by the apnea/hypopnea index (AHI) was studied. Secondary objectives were to evaluate the impact on the positional component of OSAS and to highlight possible predictors of improvement of OSAS after thyroidectomy.
  
  
  METHODS
  Twenty-eight patients with OSAS are included in this monocentric study: they underwent total thyroidectomy (n = 26) or left loboisthmectomy. Postoperative assessment involves a nocturnal control polysomnography as of 60 days after surgery.
  
  
  RESULTS
  The mean age at the time of surgery is 61.3 years (standard deviation ±7.3) and average body mass index is 29.6 kg/m2 (±7.3). Continuous positive airway pressure (CPAP) treatment is introduced preoperatively in 82% of patients. The statistical analysis shows a significant decrease of 33% in postoperative AHI for the total population (p = 0.001), 77% in patients under CPAP (p = 0.05), and 27% in patients without CPAP (p = 0.02). CPAP therapy could be released in four patients. Given the limited number of subjects studied, the surgery did not impact on the positional component of the OSAS. Statistical analysis failed to link a predictive factor to AHI reduction.
  
  
  CONCLUSIONS
  We propose thyroid surgery as an alternative or as a complement to CPAP treatment for the patients with goitre: it allows a significant decrease in postoperative AHI, allowing adaptation of the CPAP treatment downward, or even a release in some cases. These results need to be confirmed on a larger series of patients in a prospective study with standardized criteria for polysomnography and multivariate analysis.
authors.affiliation: Department of Surgical Oncology, Centre Paul Strauss, Strasbourg, France, schneider.an@orange.fr.
authors.forename: A
authors.initials: A
authors.lastname: Schneider
authors.forename: K
authors.initials: K
authors.lastname: Bourahla
authors.forename: C
authors.initials: C
authors.lastname: Petiau
authors.forename: M
authors.initials: M
authors.lastname: Velten
authors.forename: P P
authors.initials: PP
authors.lastname: Volkmar
authors.forename: J F
authors.initials: JF
authors.lastname: Rodier
mesh_terms: D000368:Aged; D015992:Body Mass Index; D015897:Comorbidity; D045422:Continuous Positive Airway Pressure; D005260:Female; D006042:Goiter / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D016896:Treatment Outcome