ENT Division, University of Eastern Piedmont, Novara, Italy.
Cranio. 2023 Jan;41(1):22-25. doi: 10.1080/08869634.2020.1792222. Epub 2020 Jul 11.
Obstructive sleep apnea (OSA) is frequently encountered in adult sleep disorders and needs careful differential diagnosis.Ear, nose, throat examination, including naso-laryngeal endoscopy, is mandatory in all cases to rule out potential obstructing lesions causing OSA.
This report presents a 64-year-old male with snoring, nasal blockage (especially during night-time), and mild OSA. Physical-examination and CT revealed a unilateral vascularized left sinonasal mass extending to the nasopharynx and protruding into the oropharynx during inhalation. Due to suspicions of malignancy or vascular tumor, the patient also underwent contrast MRI. Endoscopic surgery was performed, and the final diagnosis was a sinonasal angiomatous polyp (SAP). SAPs are rare, and this is the first reported case of an adult solitary unilateral angiomatous polyp referral for OSA.
Nasal masses need to be considered in the differential diagnosis of patients with obstructive sleep disorders in order to avoid wrong or ineffective treatment.
阻塞性睡眠呼吸暂停(OSA)在成人睡眠障碍中较为常见,需要仔细鉴别诊断。所有病例均必须进行耳鼻喉检查,包括鼻咽喉内窥镜检查,以排除可能导致 OSA 的潜在阻塞性病变。
本报告介绍了一名 64 岁男性患者,主要表现为打鼾、鼻塞(尤其是夜间)和轻度 OSA。体格检查和 CT 显示单侧血管化的左鼻窦肿块延伸至鼻咽部,并在吸气时向口咽部突出。由于怀疑为恶性肿瘤或血管性肿瘤,患者还接受了对比 MRI 检查。行内镜手术,最终诊断为鼻窦血管性息肉(SAP)。SAP 较为罕见,这是首例成人单侧孤立性血管性息肉引起 OSA 的报道。
对于阻塞性睡眠障碍患者,需要考虑鼻腔肿块在鉴别诊断中的作用,以避免错误或无效的治疗。