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Severe obstructive sleep apnea after concurrent chemoradiotherapy for laryngeal and hypopharyngeal cancer managed by CPAP

  • Ayako Inoshita
    Correspondence
    Corresponding author at: Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
    Affiliations
    Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan

    Sleep and Sleep-Disordered Breathing Center, Juntendo University Hospital, Tokyo, Japan
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  • Fumihiko Matsumoto
    Affiliations
    Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan
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  • Shinichi Ohba
    Affiliations
    Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan
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  • Naoko Sata
    Affiliations
    Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan

    Sleep and Sleep-Disordered Breathing Center, Juntendo University Hospital, Tokyo, Japan
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  • Rina Matsuoka
    Affiliations
    Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan
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  • Yo Suzuki
    Affiliations
    Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan

    Sleep and Sleep-Disordered Breathing Center, Juntendo University Hospital, Tokyo, Japan
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  • Shin Ito
    Affiliations
    Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan
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  • Hiroko Koiwai
    Affiliations
    Department of Clinical Laboratory, Juntendo University Hospital, Tokyo, Japan
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  • Nanako Shiroshita
    Affiliations
    Depart of Cardiovascular Management and Remote Monitoring, Juntendo University Graduate School of Medicine
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  • Takatoshi Kasai
    Affiliations
    Sleep and Sleep-Disordered Breathing Center, Juntendo University Hospital, Tokyo, Japan

    Depart of Cardiovascular Management and Remote Monitoring, Juntendo University Graduate School of Medicine

    Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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  • Katsuhisa Ikeda
    Affiliations
    Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan
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      Abstract

      Concurrent chemoradiotherapy (CCRT) is one of the most promising treatments for advanced head and neck cancer (HNC). On the other hand, CCRT may induce severe edema in laryngo-pharyngeal structures in association with radiation. This is a report of a 66-year-old man with severe obstructive sleep apnea (OSA) associated with edema in laryngo-hypopharynx after CCRT for advanced laryngeal and hypopharyngeal cancer. Tracheostomy was avoided and OSA was controlled by continuous positive airway pressure (CPAP). Subjective symptoms of sleepiness were improved. Though laryngeal edema appeared during the course of CCRT in this case, OSA was not evaluated until snoring had been pointed out and he complained of sleepiness. CCRT for laryngeal and hypopharyngeal cancer have a risk of occurrence of OSA due to irreversible mucous edema in the upper airway. Patients for whom CCRT is planned should be informed about the occurrence of OSA before the treatment because symptoms associated with OSA can negatively impact not only the daytime quality of life but also increase the risk of cardiovascular events. The OSA treatment for post CCRT would be expected to have a positive impact on not only cardiovascular and metabolic systems but also on the cancer treatment survival rate.

      Keywords

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