CONTINUOUS POSITIVE AIRWAY PRESSURE IS EFFECTIVE IN TREATING UPPER AIRWAY EDEMA

The case of a patient with diffuse idiopathic skeletal hyperostosis (D ISH) and upper airway oedema, is described. The patient presented with alveolar hypoventilation and obstructive apnoeas during sleep. Intrav enous steroids (methylprednisolone, 160 mg . day(-1)) for 5 days did n ot reduce the oedema. However, it was rapidly reversed by the use of n asal continuous positive airway pressure (nCPAP). In addition, daytime pulmonary gas exchange was improved and sleep apnoea abolished, This beneficial effect made tracheostomy unnecessary. This case report sugg ests that CPAP can be a potentially useful therapeutic alternative to tracheostomy in the clinical management of upper airway oedema.