Gutierrez T, Leong A C, Pang L, Chevretton E, Jeannon J-P, Simo R
Department of Otorhinolaryngology and Head and Neck Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK.
J Laryngol Otol. 2012 Feb;126(2):190-5. doi: 10.1017/S0022215111002714. Epub 2011 Oct 12.
Obstructive sleep apnoea syndrome has been linked to obesity, nasal obstruction and adenotonsillar hypertrophy, but rarely to large thyroid goitres.
To study the possible association between multinodular retrolaryngo-pharyngeal or retrosternal goitres and obstructive sleep apnoea syndrome.
Retrospective case series at a tertiary referral centre (2000-2010). Study parameters included body mass index, Epworth sleep score and polysomnographic index.
Five patients were diagnosed with obstructive sleep apnoea syndrome and managed with nasal continuous positive airway pressure ventilation. Computed tomography showed a retrolaryngo-pharyngeal or retrosternal goitre with significant tracheal compression, displacement and laryngeal oedema. After total thyroidectomy, obstructive sleep apnoea resolved in all patients.
Large, multinodular goitres with retrolaryngo-pharyngeal extension can cause obstructive sleep apnoea syndrome due to laryngeal compression and oedema. In such cases, total thyroidectomy enables resolution of symptoms. Patients with obstructive sleep apnoea syndrome should be screened for thyroid goitre.
阻塞性睡眠呼吸暂停综合征与肥胖、鼻阻塞及腺样体扁桃体肥大有关，但与巨大甲状腺肿关系罕见。
研究多结节性喉后或胸骨后甲状腺肿与阻塞性睡眠呼吸暂停综合征之间的可能关联。
在一家三级转诊中心进行回顾性病例系列研究（2000 - 2010年）。研究参数包括体重指数、爱泼沃斯嗜睡量表评分及多导睡眠图指标。
5例患者被诊断为阻塞性睡眠呼吸暂停综合征，并采用鼻持续气道正压通气治疗。计算机断层扫描显示喉后或胸骨后甲状腺肿伴有明显气管受压、移位及喉部水肿。全甲状腺切除术后，所有患者的阻塞性睡眠呼吸暂停均得到缓解。
伴有喉后延伸的巨大多结节性甲状腺肿可因喉部受压和水肿导致阻塞性睡眠呼吸暂停综合征。在此类病例中，全甲状腺切除术可使症状缓解。阻塞性睡眠呼吸暂停综合征患者应筛查甲状腺肿。
