Ablation of excess mucosa around aryepiglottic folds during drug-induced sleep endoscopy to treat obstructive sleep apnoea: a case report.

Abstract

Objective: Redundant supraglottic and laryngeal mucosa associated with obstructive sleep apnoea is a rare pathology with limited representation in the literature. This article presents the novel case of a 40-year-old male patient with obstructive sleep apnoea for whom previous conservative treatments proved ineffective.

Methods: Drug-induced sleep endoscopy identified excess mucosa around the aryepiglottic folds leading to laryngeal inlet occlusion during inspiration and resulting in apnoeic episodes.

Results: Following drug-induced sleep endoscopy, targeted ablation of the redundant mucosa was performed, leading to improvements in their obstructive sleep apnoea and subjective quality of life. This case represents the first report with videographic evidence of drug-induced sleep endoscopy used both for pre-treatment phenotyping and post-treatment assessment of this condition.

Conclusion: Although the pathophysiological mechanisms linking redundant supraglottic mucosa to obstructive sleep apnoea remain poorly understood, drug-induced sleep endoscopy has proven to be a valuable diagnostic tool. The authors advocate for routine airway examination extending to the larynx to identify patients with this condition.