Obstructive Sleep Apnoea in Patients Treated for Head and Neck Cancer: A Systematic Review of the Literature

Abstract

Background and objectives: Obstructive sleep apnoea (OSA) is clinically defined by signs of daytime sleepiness and objective measures of disordered breathing during sleep. The literature is still controversial on the incidence and aetiology of OSA secondary to head and neck cancer treatment. The aim of this systematic review is to evaluate and discuss the prevalence of OSA in patients treated with surgery and/or chemo/radiotherapy for head and neck cancer. Materials and methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was performed on May 2020 using the MEDLINE database, Scopus, and Google Scholar. The searches were conducted using combinations of the following terms: head and neck cancer, OSA, radiotherapy, chemotherapy, partial laryngectomy, laryngeal cancer, neoplasm, tumour, carcinoma, and oropharyngeal cancer. Results: Our results suggest that head and neck cancer patients have a higher incidence of OSA (59.78%) compared to the general population; differences may occur based on the type of treatment. Conclusions: Clinicians should recognise the higher prevalence of OSA in patients treated for head and neck cancer and should consider a comprehensive sleep history as part of the evaluation and management of these patients. Further research is needed to evaluate the exact prevalence, aetiology, and correct management of OSA after treatment for head and neck cancer.

Quality of Life and Aesthetic Satisfaction in Patients Who Underwent the “Commando Operation” with Pectoralis Major Myocutaneus Flap Reconstruction—A Case Series Study

“…Since our patients, along with the intraoral resection, underwent modified radical neck dissection and reconstruction with the bulky the pectoralis major myocutaneus flap, it can be implicated that due to the changed anatomical and neuromuscular relations, they could possibly have a higher prevalence of obstructive sleep apnea. Moreover, recent systematic review results suggested that head and neck cancer patients have a higher incidence of obstructive sleep apnea when compared to the general population [ 47 ]. However, these results should be taken with caution since the exact etiology and subsequent correct management in these patients still needs to be addressed.…”

Impact of free flap reconstruction on obstructive sleep apnea in patients with oral and oropharyngeal cancer

“…In this study, we discovered that the incidence of OSA among patients with OOCs before surgery was 91.3%, which was considerably higher than that in individuals without such cancer. 6 , 7 According to an epidemiological survey on OSA, 6 the prevalence of OSA for men and females in European and American countries was 17%–26% and 9%–50%, respectively; in Asian countries, it was 8.8%–37.4% and 3.7%–16%, respectively; and globally, it was 22% and 17%, respectively. This may be because the tumor in the respiratory tract narrows the respiratory tract, thereby increasing airflow resistance.…”

Obstructive Sleep Apnea in Patients with Head and Neck Cancer—More than Just a Comorbidity?

“…OSA, as well as HNSCC, causes poor quality of life. In a systematic review of 10 prospective studies on the subject, OSA incidence ranged from 12% to 95.8%, with a weighted average of 59.78% on patients treated for head and neck cancer [22].…”

“…Head and neck cancer ranks among the top ten most common types of cancer worldwide with a severe impact on quality of life and elevated mortality in affected individuals [20,21]. Although there appears to be an elevated OSA incidence in patients with head and neck cancer, this comorbidity and particularly its possible linkage has been poorly studied in small prospective studies [22].…”