Cerri Luca, Giombi Francesco, Cerasuolo Michele, Pace Gian Marco, Losurdo Anna, Lunardi Giuseppe, Grecchi Francesco, Volpini Elena, Malvezzi Luca
Otorhinolaryngology-Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy.
J Pers Med. 2025 Jul 28;15(8):331. doi: 10.3390/jpm15080331.
: Obstructive sleep apnea syndrome (OSAS) is caused by anatomical and non-anatomical factors which lead to upper airway (UA) obstruction during sleep. Intrinsic UA collapse is the most frequent determinant of OSA. In the era of personalized medicine, adopting a tailored diagnostic approach is essential to rule out secondary causes of UA collapse, particularly those stemming from extrinsic anatomical factors. Although being rarely considered in the differential diagnosis, space-occupying lesions of deep cervical spaces such as the parapharyngeal space (PPS) may be responsible for airway obstruction and lead to OSAS. : This study aimed to present an atypical case of OSAS caused by extrinsic PPS compression, outlining the relevance of modern personalized medicine in the diagnostic and therapeutic protocols, and to enhance understanding through a comprehensive literature review. : A 60-year-old female presented with sleep-disordered complaints and was diagnosed with severe OSAS after polysomnography. At physical examination, a swelling of the right posterior oropharyngeal mucosa was noticed. Imaging confirmed the suspicion of a PPS tumor, and transcervical resection was planned. Case presentation was adherent to the CARE checklist. A comprehensive literature review was conducted using the most reliable scientific databases. : Surgery was uneventful, and the patient made a full recovery. The histopathology report was consistent with the diagnosis of pleomorphic adenoma. Postoperative outcomes showed marked improvement in polysomnographic parameters and symptom burden. : Parapharyngeal space tumors are a rare, often overlooked cause of OSA. This case highlights the role of a personalized head and neck assessment in OSA patients, particularly in identifying structural causes and offering definitive surgical management when indicated.
阻塞性睡眠呼吸暂停综合征（OSAS）由解剖学和非解剖学因素引起，这些因素导致睡眠期间上呼吸道（UA）阻塞。UA内在塌陷是OSA最常见的决定因素。在个性化医疗时代，采用量身定制的诊断方法对于排除UA塌陷的继发原因至关重要，尤其是那些源于外在解剖学因素的原因。尽管在鉴别诊断中很少被考虑，但深部颈部间隙（如咽旁间隙，PPS）的占位性病变可能导致气道阻塞并引发OSAS。本研究旨在介绍一例由外在PPS压迫引起的非典型OSAS病例，概述现代个性化医疗在诊断和治疗方案中的相关性，并通过全面的文献综述增进理解。一名60岁女性因睡眠障碍主诉就诊，经多导睡眠图检查后被诊断为重度OSAS。体格检查时，发现右侧口咽后黏膜肿胀。影像学检查证实怀疑为PPS肿瘤，并计划进行经颈切除术。病例报告遵循CARE检查表。使用最可靠的科学数据库进行了全面的文献综述。手术顺利，患者完全康复。组织病理学报告与多形性腺瘤的诊断一致。术后结果显示多导睡眠图参数和症状负担有显著改善。咽旁间隙肿瘤是OSA一种罕见且常被忽视的病因。该病例突出了个性化头颈部评估在OSA患者中的作用，特别是在识别结构病因并在有指征时提供确定性手术治疗方面。
