1/3. Orolaryngeal sarcoidosis presenting as obstructive sleep apnoea.A 53-year-old man was evaluated for snoring, dysphagia for solid foods and difficulty of breathing and a polysomnographic recording was consistent with a diagnosis of obstructive sleep apnoea syndrome (OSAS). A flexible fiberoptic bronchoscopy (FFB) showed the presence of a nodular lesion of the posterior ventral surface of the tongue strictly connected to the left lateral border of the epiglottis. The biopsy specimen taken from the lesion was consistent with sarcoidosis. No involvement of pulmonary parenchyma, lymph nodes or other organs was recognized. After two months of steroid treatment, symptoms disappeared and resolution of the nodular lesion at the FFB and normalization of the polysomnographic recording were observed. This is the first report of orolaryngeal sarcoidosis associated with OSAS as the only clinical presentation of the disease.- - - - - - - - - - ranking = 1keywords = apnoea (Clic here for more details about this article) |
2/3. Brief upper airway dysfunction.We have analysed the clinical manifestations of nine patients with brief upper airway dysfunction (BUAD) who attended the thoracic department of a major teaching hospital between 1987 and 1991. Episodes of BUAD developed within 1-4 months of presentation in three patients but were undiagnosed for 2.5-12.5 years in six. The mean age at onset was 51 years ranging from 37 to 66 years. The episodes occurred at irregular intervals. They lasted approximately 1-5 min, were frightening and consisted of an initial phase of obstructive apneoa lasting a few seconds to 2 min and a second phase of respiratory distress with inspiratory stridor lasting 1-4 min. Daytime episodes occurred in all and at night in five, waking three of the patients from sleep. In most instances, throat irritability triggered the episodes which were often preceded by cough. Potential causes of throat irritability included respiratory tract infection, allergy, oesophageal reflux and obstructive sleep apnoea. After treatment of throat irritability BUAD has ceased for at least a year in six of the eight with adequate follow-up. In conclusion, BUAD has characteristics clinical features which should enable it to be recognized more frequently, ensuring successful management.- - - - - - - - - - ranking = 0.2keywords = apnoea (Clic here for more details about this article) |
3/3. Upper airways sarcoidosis presenting as obstructive sleep apnoea.sarcoidosis may present in a number of different ways, affecting many organ systems. The case history is presented of a 32 year old woman who presented with symptoms of severe obstructive sleep apnoea (OSA) due to infiltration of the upper airway by sarcoidosis. To our knowledge this presentation of sarcoidosis has not previously been described.- - - - - - - - - - ranking = 1keywords = apnoea (Clic here for more details about this article) |