Severe obstructive sleep apnea after concurrent chemoradiotherapy for laryngeal and hypopharyngeal cancer managed by CPAP
Severe obstructive sleep apnea after concurrent chemoradiotherapy for laryngeal and hypopharyngeal cancer managed by CPAP
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DOI：
10.1016/j.anl.2021.05.003
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发表时间：
2022-07-04
影响因子：
1.7
通讯作者：
Ikeda, Katsuhisa
中科院分区：
文献类型：
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作者：
Inoshita, Ayako;Matsumoto, Fumihiko;Ikeda, Katsuhisa
同步放化疗（CCRT）是治疗晚期头颈癌（HNC）最有前途的方法之一。另一方面，CCRT可能诱发与放射相关的咽喉结构严重水肿。本文报告一位66岁男性患者，因严重阻塞性睡眠呼吸暂停（OSA）合并喉-下咽部水肿，接受了晚期喉癌和下咽癌的CCRT治疗。避免气管切开，并通过持续气道正压通气（CPAP）控制OSA。嗜睡的主观症状得到改善。虽然在这个病例中，在CCRT过程中出现了喉部水肿，但直到打鼾被指出并抱怨困倦时才对OSA进行评估。喉癌和下咽癌的CCRT有发生OSA的风险，因为上呼吸道中存在不可逆的粘膜水肿。计划接受CCRT的患者应在治疗前告知OSA的发生，因为与OSA相关的症状不仅会对日间生活质量产生负面影响，还会增加心血管事件的风险。预计CCRT后的OSA治疗不仅对心血管和代谢系统，而且对癌症治疗存活率产生积极影响。(c)2021日本耳鼻咽喉头颈外科学会Elsevier B. V.出版，保留所有权利。
Concurrent chemoradiotherapy (CCRT) is one of the most promising treatments for advanced head and neck cancer (HNC). On the other hand, CCRT may induce severe edema in laryngo-pharyngeal structures in association with radiation. This is a report of a 66-year-old man with severe obstructive sleep apnea (OSA) associated with edema in laryngo-hypopharynx after CCRT for advanced laryngeal and hypopharyngeal cancer. Tracheostomy was avoided and OSA was controlled by continuous positive airway pressure (CPAP). Subjective symptoms of sleepiness were improved. Though laryngeal edema appeared during the course of CCRT in this case, OSA was not evaluated until snoring had been pointed out and he complained of sleepiness. CCRT for laryngeal and hypopharyngeal cancer have a risk of occurrence of OSA due to irreversible mucous edema in the upper airway. Patients for whom CCRT is planned should be informed about the occurrence of OSA before the treatment because symptoms associated with OSA can negatively impact not only the daytime quality of life but also increase the risk of cardiovascular events. The OSA treatment for post CCRT would be expected to have a positive impact on not only cardiovascular and metabolic systems but also on the cancer treatment survival rate.(c) 2021 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.