Cervical Sympathetic Neurofibroma Masquerading as Obstructive Sleep Apnea Syndrome

Gopinath, M; Ramachandran, VV; Jose, Rohini

doi:10.5005/jp-journals-10023-1022

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…A variety of both covid and non-covid atypical pathologies have presented as crops/clusters since the start of Covid-19 pandemic [5,6] with symptomatology masking primary disease. This study helped to determine the importance of establishing clinical suspicion of overt pathologies in selected cases which masquerade as Obstructive sleep apnea (OSA) [7,8]. OSA has emerged as a global disease with causes being multi-factorial [9] with varied presentations [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Covid-19 and Obstructive Sleep Apnea: The Theatricals and Quality-of-Life Impact

Sudarsan

Kumar

Chalamaiahgari

et al. 2023

Indian J Otolaryngol Head Neck Surg

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COVID-19 caused by SARS-CoV2 has reached pandemic proportions. The fear of Covid-19 has deterred many to abandon efforts for seeking timely medical help. In this setting, Obstructive sleep apnea (OSA)-like covid/non-covid cohorts have presented. Atypical pathologies can present like OSA and take the clinician unawares. With this series of misfits suffering silently, it would be unwise to underestimate its impact on quality-of-life (QOL). To determine the effect on quality-of-life by pathologies mimicking OSA and assess Covid-19 as a cause for delayed presentation. This was a prospective cross-sectional study. 127(N). Recent onset of symptoms of OSA. Study duration March 2020 to September 2021. Pittsburgh Sleep Quality Index (PSQI) screening done. Study criteria defined. Sleep parameters calculated. Primary surgical intervention given. Non-responders were put on CPAP therapy. QOL assessment done with sf-36 and SAQLI. Fear of Covid-19 scale (FCV-19S) quantified to study cause for temporal delay. Correlations computed. Level of Evidence—Level 3. 97 candidates completed study. Demographic and anthropometric details noted. Mean range was 43.85 ± 11.39 years. Male predominance. Overall AHI-19.73 ± 8.72. Moderate impact on QOL by sf-36/SAQLI. 78n Primary surgical candidates fared well. Polysomnography (PSG) and Continuous positive airway pressure (CPAP) titration/trial characteristics for 19n available. Statistically significant improvement in QOL after treatment completion. Correlations were meaningful. Body Mass Index (BMI) as a single factor was not influential on OSA-mimickers. Fear of Covid-19 significantly impacted emergency medical aid acquisition. OSA mimicking atypical airway pathologies may need emergent treatment not only from a surgical point-of-view but also from the QOL of the patient. On the contrary, these also unmask sub-clinical OSA, especially in patients with low/normal BMI. This category of recent onset OSA, if fortunately picked up at the earliest possible presentation, may hopefully not go through the significant QOL impact suffered by chronic OSA candidates.

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Section: Introductionmentioning

confidence: 99%

Covid-19 and Obstructive Sleep Apnea: The Theatricals and Quality-of-Life Impact

Sudarsan

Kumar

Chalamaiahgari

et al. 2023

Indian J Otolaryngol Head Neck Surg

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Sleep-disordered breathing due to parapharyngeal space plexiform neurofibroma in neurofibromatosis-1: a case report and literature review

Balakrishnan

Bhatia

Deka

et al. 2023

Egypt J Otolaryngol

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Background Neurofibromatosis type 1 is an autosomal dominant disorder with an incidence of 1 in 3000 births. Neurofibromas can occur anywhere in the body. Of all the head and neck tumours parapharyngeal space tumours constitute 0.5%. Neurofibromas can constitute about 9% of all the neurogenic tumours (41%) of the parapharyngeal space. Prevalence of nasal obstruction and obstructive sleep-disordered breathing symptoms due to Plexiform neurofibroma in Neurofibromatosis type 1 is rare amounting to less than 0.5% of cases of parapharyngeal space tumours. Case presentation We present a case report of a 24-year-old female patient of Neurofibromatosis type 1 who presented with obstructive sleep-disordered breathing symptoms due to Plexiform neurofibroma in the parapharyngeal space. She had complaints of progressive nasal obstruction with associated snoring, disturbed sleep, and daytime somnolence without any significantly large external neck swelling. She underwent excision of the right parapharyngeal tumor by combined trans parotid and transcervical approach. After histopathological examination, a diagnosis of Plexiform neurofibroma was made. On 1-year follow-up, she is doing well without any recurrence and her presenting symptoms of obstructive sleep-disordered breathing symptoms had improved. Conclusion The symptoms of obstructive sleep-disordered breathing symptoms need to be kept in mind while evaluating such patients and careful attention needs to be given to the patients who report disturbed sleep. Neurofibromatosis type 1 is a multi-system disease which needs holistic care and approach. Such patients should be offered symptomatic treatment and leading questions on the quality of sleep should be asked. Any treatable cause of disturbed sleep like organic sleep disorder should be treated promptly in such patients.

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Cervical Sympathetic Neurofibroma Masquerading as Obstructive Sleep Apnea Syndrome

Cited by 2 publications

References 8 publications

Covid-19 and Obstructive Sleep Apnea: The Theatricals and Quality-of-Life Impact

Covid-19 and Obstructive Sleep Apnea: The Theatricals and Quality-of-Life Impact

Sleep-disordered breathing due to parapharyngeal space plexiform neurofibroma in neurofibromatosis-1: a case report and literature review

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