Eyigor Hulya, Selcuk Omer Tarik, Osma Ustun, Koca Rahime, Yilmaz Mustafa Deniz
Department of ENT Head and Neck Surgery, Antalya Education and Research Hospital, Antalya, Turkey.
J Craniofac Surg. 2012 Sep;23(5):e444-6. doi: 10.1097/SCS.0b013e318260e9ea.
Uncertain etiology of cervical osteophytes, in particular emerging in geriatric population, is a rare skeletal system disease. Often, the cases are asymptomatic and may lead to symptoms such as dysphagia, cough, dyspnea, and dysphonia. We present a patient who had anterior osteophytes causing symptoms of severe obstructive sleep apnea (OSA), and literature on etiology of OSA has been reviewed. A 57-year-old male patient with complaints of snoring and cessation of breathing during sleep was referred to the ear nose throat clinic. Cervical radiograph and computed tomography showed the osteophytes in the anterior of the vertebral corpus at the level C1-2. In addition, bridging osteophyte was observed between C6 and C7 vertebrae. The patient's neck circumference was 41 cm, body mass index was 29 kg/m2, Epworth Sleepiness Scale score was 11, and apnea hypopnea index was 62. Surgery was recommended, but the patient refused. Continuous positive airway pressure titration was applied with 12.6 cm H2O pressure; apnea control was attained with an AHI of 2.7. One of the rare causes of OSA, a case of cervical vertebral osteophyte, was presented, and we would like to draw attention to the importance of ear nose throat examination in the diagnosis of OSA.
颈椎骨赘病因不明,尤其在老年人群中出现,是一种罕见的骨骼系统疾病。通常情况下,这些病例无症状,可能会导致吞咽困难、咳嗽、呼吸困难和声音嘶哑等症状。我们报告一例因前方骨赘导致严重阻塞性睡眠呼吸暂停(OSA)症状的患者,并对OSA的病因相关文献进行了综述。一名57岁男性患者,因睡眠时打鼾和呼吸暂停前来耳鼻喉科就诊。颈椎X线片和计算机断层扫描显示C1 - 2椎体水平前方有骨赘。此外,在C6和C7椎体之间观察到桥接骨赘。患者颈围41 cm,体重指数29 kg/m²,爱泼华嗜睡量表评分为11分,呼吸暂停低通气指数为62。建议手术治疗,但患者拒绝。采用12.6 cm H₂O压力进行持续气道正压滴定;呼吸暂停得到控制,呼吸暂停低通气指数为2.7。本文报告了一例罕见的OSA病因——颈椎椎体骨赘病例,并提请注意耳鼻喉科检查在OSA诊断中的重要性。