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CC BY-NC-ND 4.0 · Sleep Sci
DOI: 10.1055/s-0044-1787531
Case Report

“Unveiling Unique Pathologies in Obstructive Sleep Apnea: Two Intriguing Case Reports”

Peter M. Baptista 
1   Department of ENT, Clinica Universidad de Navarra, Pamplona, Navarra, Spain
2   Department of ENT, Alzahra Hospital, Dubai, United Arab Emirates
,
Carlos O'connor
3   Department of ENT, Hospitales Quironsalud Marbella y Campo de Gibraltar, Spain
,
Mahran Altoron
2   Department of ENT, Alzahra Hospital, Dubai, United Arab Emirates
,
Laura Rodriguez-Alcala
3   Department of ENT, Hospitales Quironsalud Marbella y Campo de Gibraltar, Spain
,
Guillermo Plaza-Mayor
4   Department of ENT, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Madrid, Spain
› Author Affiliations Funding This article has not received any funding.
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Abstract

Obstructive sleep apnea (OSA) is often associated with reduced pharyngeal muscle tone and an anatomically narrowed pharyngeal airspace. We try to describe two cases with OSA that were diagnosed with vascular lesions during DISE: One of them was an aberrant internal carotid artery, and the second one was a glomus tumor. These anatomic anomalies contribute to airspace narrowing in these patients. These two cases describe an exciting presentation of sleep apnea and remind us of the importance of clinically recognizing vascular alterations to avoid damage during routine oropharyngeal procedures.

Keywords

drug-induced sleep endoscopy - obstructive sleep apnea - glomus tumor - aberrant internal carotid artery


Publication History

Received: 20 August 2023

Accepted: 07 February 2024

Article published online:
05 June 2024

© 2024. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Ozgur Z, Celik S, Govsa F, Aktug H, Ozgur T. A study of the course of the internal carotid artery in the parapharyngeal space and its clinical importance. Eur Arch Otorhinolaryngol 2007; 264 (12) 1483-1489
    CrossrefPubMedGoogle Scholar
  • 2 Wasserman JM, Sclafani SJ, Goldstein NA. Intraoperative evaluation of a pulsatile oropharyngeal mass during adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2006; 70 (02) 371-375
    CrossrefPubMedGoogle Scholar
  • 3 Jackson CG, Glasscock ME, Harris PF. et al. Glomus jugulare tumors. J Neurosurg 1982; 57 (06) 700-704
    Google Scholar
  • 4 Yucel A, Unlu M, Haktanir A, Acar M, Fidan F. Evaluation of the upper airway cross-sectional area changes in different degrees of severity of obstructive sleep apnea syndrome: cephalometric and dynamic CT study. AJNR Am J Neuroradiol 2005; 26 (10) 2624-2629
    PubMedGoogle Scholar
  • 5 Lee JH, Baek BJ, Kim KW. et al. Glomus tumor in the parapharyngeal space. Eur Arch Otorhinolaryngol 2004; 261 (08) 441-444
    Google Scholar
  • 6 Patil SP, Schneider H, Schwartz AR, Smith PL. Adult obstructive sleep apnea: pathophysiology and diagnosis. Chest 2007; 132 (01) 325-337
    CrossrefPubMedGoogle Scholar
  • 7 Paulsen F, Tillmann B, Christofides C, Richter W, Koebke J. Curving and looping of the internal carotid artery in relation to the pharynx: frequency, embryology and clinical implications. J Anat 2000; 197 (Pt 3): 373-381
    CrossrefPubMedGoogle Scholar
  • 8 Lim HJ, Sharma S, Sheahan P. Head and neck paragangliomas: An overview. J Clin Neurosci 2010; 17 (05) 595-600
    Google Scholar
  • 9 Picel AC, Davidson TM. An aberrant internal carotid artery discovered during evaluation of obstructive sleep apnea: a report of 2 cases with consideration of a possible association. Ear Nose Throat J 2011; 90 (01) 29-31
    CrossrefPubMedGoogle Scholar
  • 10 Duygulu G. Relationship of aberrant internal carotid artery with pharyngeal wall in obstructive sleep apnea. Sleep Breath 2023; 27 (06) 2415-2422 DOI: 10.1007/s11325-023-02871-8.
    CrossrefPubMedGoogle Scholar
  • 11 Marks SC, Rimmer J, Anand VK. et al. Paragangliomas of the head and neck: Treatment outcomes and novel approaches for the difficult-to-treat tumors. Skull Base Surg 2009; 19 (02) 129-137
    Google Scholar
  • 12 Havekes B, Kastelein F, van der Klaauw AA. et al. Head-and-neck paragangliomas are associated with sleep-related complaints, especially in the presence of carotid body tumors. Sleep Breath 2012; 16 (02) 527-534 DOI: 10.1007/s11325-011-0538-5.
    CrossrefPubMedGoogle Scholar
  • 13 van Hulsteijn LT, van Duinen N, Ninaber MK. et al. Carotid body tumors are not associated with an increased risk for sleep-disordered breathing. Sleep Breath 2014; 18 (01) 103-109
    CrossrefPubMedGoogle Scholar
  • 14 Vrabec DP, Dedo HH, Cole JW, Ogura JH. Glomus jugulare tumors: Diagnosis, treatment, and results. Ann Otol Rhinol Laryngol 1981; 90 (3 Pt 1): 197-201
    Google Scholar