Aziz Luaay, Ejnell Hasse
Department of Otorhinolaryngology-Head and Neck Surgery, Sahlgrenska University Hospital, S-431 45, Göteborg, Sweden.
Ear Nose Throat J. 2003 Apr;82(4):326-7.
We describe the case of a woman who had been referred to us with a history of breathing difficulties and snoring and a suspicion of obstructive sleep apnea (OSA). Our investigation revealed that she did indeed have severe OSA in addition to undiagnosed bilateral vocal fold paralysis of unknown origin. Nocturnal polysomnography found that her apnea/hypopnea index was 120 and her minimum arterial oxygen saturation level was 63%. She was treated with laterofixation of the right vocal fold, and her OSA resolved immediately. During 10 years of follow-up with nocturnal polysomnogrpahy, no recurrence of apnea or low oxygen saturation levels was noted. However, she did experience a recurrence of her snoring 4 years postoperatively, along with the onset of progressively worsening daytime fatigue. When these conditions persisted, we performed a repeat laterofixation of the same vocal fold. Following the repeat surgery, subjectively and objectively assessed results were good.
我们描述了一位女性患者的病例，她因呼吸困难和打鼾病史被转诊至我们这里，怀疑患有阻塞性睡眠呼吸暂停（OSA）。我们的检查发现，除了病因不明的未确诊双侧声带麻痹外，她确实患有严重的OSA。夜间多导睡眠图显示，她的呼吸暂停/低通气指数为120，最低动脉血氧饱和度水平为63%。她接受了右侧声带外侧固定术，术后OSA立即得到缓解。在随后10年的夜间多导睡眠图随访中，未发现呼吸暂停或低氧饱和度水平复发。然而，术后4年她的打鼾复发，同时出现了逐渐加重的日间疲劳。当这些情况持续存在时，我们对同一声带进行了再次外侧固定术。再次手术后，主观和客观评估结果均良好。
