Cadieux R J, Kales A, McGlynn T J, Jackson D, Manders E K, Simmonds M A
Arch Otolaryngol. 1984 Sep;110(9):611-3. doi: 10.1001/archotol.1984.00800350053014.
A patient was seen for evaluation of excessive daytime sleepiness, which was exacerbated following complications secondary to surgical reconstruction of the pharynx for a submucous cleft palate. She underwent recordings in the sleep laboratory and was found to have sleep apnea. Also, a thorough clinical and laboratory assessment established the diagnosis of myotonic dystrophy. Following tracheostomy, both the patient's sleep apnea and daytime hypersomnia were eliminated. Our case demonstrates that surgical procedures involving the upper airway should be approached with considerable caution in patients with myotonic dystrophy and only after the presence of associated sleep apnea has been carefully excluded. An original finding is the suggestion of a decrease in the number of T-cell lymphocytes in a patient with myotonic dystrophy.
一名患者因日间过度嗜睡前来就诊，该症状在因黏膜下腭裂进行咽部手术重建继发并发症后加重。她在睡眠实验室进行了记录，发现患有睡眠呼吸暂停。此外，经过全面的临床和实验室评估，确诊为强直性肌营养不良。气管切开术后，患者的睡眠呼吸暂停和日间嗜睡均消失。我们的病例表明，对于强直性肌营养不良患者，涉及上呼吸道的手术应格外谨慎，且只有在仔细排除相关睡眠呼吸暂停后才能进行。一个新发现是，强直性肌营养不良患者的T细胞淋巴细胞数量有减少的迹象。
