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Ablation of excess mucosa around aryepiglottic folds during drug-induced sleep endoscopy to treat obstructive sleep apnoea: a case report

Published online by Cambridge University Press:  04 April 2025

Mohamedbaqir Rassan
Affiliation:
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
Kimberly D’Mello*
Affiliation:
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
David Roshan
Affiliation:
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand Department of Otolaryngology, Tauranga Hospital, Bay of Plenty, New Zealand
Christopher Low
Affiliation:
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand Department of Otolaryngology, Tauranga Hospital, Bay of Plenty, New Zealand Grace Hospital, Pyes Pa, Tauranga, BOP, New Zealand
Justin Imrie
Affiliation:
Grace Hospital, Pyes Pa, Tauranga, BOP, New Zealand
*
Corresponding author: Kimberly D’Mello; Email: kimberlydmello98@gmail.com

Abstract

Objective

Redundant supraglottic and laryngeal mucosa associated with obstructive sleep apnoea is a rare pathology with limited representation in the literature. This article presents the novel case of a 40-year-old male patient with obstructive sleep apnoea for whom previous conservative treatments proved ineffective.

Methods

Drug-induced sleep endoscopy identified excess mucosa around the aryepiglottic folds leading to laryngeal inlet occlusion during inspiration and resulting in apnoeic episodes.

Results

Following drug-induced sleep endoscopy, targeted ablation of the redundant mucosa was performed, leading to improvements in their obstructive sleep apnoea and subjective quality of life. This case represents the first report with videographic evidence of drug-induced sleep endoscopy used both for pre-treatment phenotyping and post-treatment assessment of this condition.

Conclusion

Although the pathophysiological mechanisms linking redundant supraglottic mucosa to obstructive sleep apnoea remain poorly understood, drug-induced sleep endoscopy has proven to be a valuable diagnostic tool. The authors advocate for routine airway examination extending to the larynx to identify patients with this condition.

Type
Clinical Records
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

This paper was presented at 77th Annual General and Scientific Meeting of the New Zealand Society of Otolaryngology - Head and Neck Surgery, 15th October 2024, Hamilton, New Zealand.

Mohamedbaqir Rassan takes responsibility for the integrity of the content of the paper

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