Ali Kamran A, Ma Daniel X, McCullough Lindsay M, Herdegen James J, Wrenn Sean M
Department of Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Rush Medical College, Rush University Medical Center, Chicago, Illinois, USA.
Case Rep Endocrinol. 2025 May 5;2025:6446712. doi: 10.1155/crie/6446712. eCollection 2025.
Obstructive sleep apnea (OSA) and nontoxic multinodular goiter are conditions that often coexist. Treatments of both conditions have evolved over time, but continuous positive airway pressure (CPAP), oral appliances, or surgical therapy are often needed. Radiofrequency ablation (RFA) of the soft palate and base of tongue has been applied as a newer alternative therapy for OSA. RFA is also an increasingly used approach for thyroid nodules and goiter, but previously had no known connection to OSA. : A 59-year-old female with a known history of multinodular goiter and moderate OSA was referred to our endocrine surgery clinic. The goiter was found to have mediastinal extension, documented longitudinal growth of the dominant nodule, cosmetic deformity of the neck, and tracheal deviation. The patient underwent thyroid RFA as nonoperative treatment for her goiter. Within a month of her procedure, she also self-reported a subjective reduction in apneic events and later underwent a formal home sleep study demonstrating an apnea-hypopnea index (AHI) change from 15.8/h at diagnosis to 2.9/h currently, signifying resolution of her OSA. Her treated nodule had 92% volume reduction on 18-month follow-up visit. : To our knowledge, this is the first reported case of OSA cured in a patient undergoing RFA for goiter. Goiter-associated sleep apnea remains inadequately described in the literature and warrants further investigations on prevalence and management. Thyroidectomy continues to be the definitive treatment for goiter, with some studies suggesting secondary efficacy for OSA. RFA is now established as a first-line option for symptomatic thyroid nodules, but previously had no described benefit to OSA symptoms. This report illustrates that RFA of thyroid nodules could be offered to patients as both an effective nonsurgical option for goiter as well as a potential cure for their OSA to free them from nightly CPAP usage.
阻塞性睡眠呼吸暂停（OSA）与非毒性多结节性甲状腺肿常并存。这两种疾病的治疗方法都随着时间不断发展，但通常需要持续气道正压通气（CPAP）、口腔矫治器或手术治疗。软腭和舌根的射频消融（RFA）已被用作治疗OSA的一种新的替代疗法。RFA也是甲状腺结节和甲状腺肿越来越常用的治疗方法，但此前尚无其与OSA相关的报道。：一名59岁女性，有已知的多结节性甲状腺肿病史及中度OSA，被转诊至我们的内分泌外科门诊。发现甲状腺肿有纵隔延伸，主要结节有纵向生长记录，颈部有美容畸形，且气管有偏移。该患者接受了甲状腺RFA作为甲状腺肿的非手术治疗。在治疗后的一个月内，她还自我报告呼吸暂停事件主观上有所减少，随后进行了正式的家庭睡眠研究，结果显示呼吸暂停低通气指数（AHI）从诊断时的15.8次/小时变为目前的2.9次/小时，表明其OSA已得到缓解。在18个月的随访中，她接受治疗的结节体积缩小了92%。：据我们所知，这是首例因甲状腺肿接受RFA治疗而治愈OSA的病例报道。甲状腺肿相关的睡眠呼吸暂停在文献中仍描述不足，需要对其患病率和管理进行进一步研究。甲状腺切除术仍然是甲状腺肿的确定性治疗方法，一些研究表明其对OSA有次要疗效。RFA现已成为有症状甲状腺结节的一线治疗选择，但此前尚无其对OSA症状有益的报道。本报告表明，甲状腺结节的RFA可为患者提供一种有效的甲状腺肿非手术治疗选择，同时也可能治愈其OSA，使其无需每晚使用CPAP。
