THE EPIGLOTTIS AND OBSTRUCTIVE SLEEP-APNEA SYNDROME

Obstructive sleep apnoea syndrome (OSAS) is caused by obstruction or n arrowing of the airway at various levels. The repair of one site only will not alleviate the syndrome if there are obstructions in other sit es. Epiglottis prolapse during inspiration is an unusual cause of airw ay obstruction and a rare cause of OSA. Twelve cases of OSAS due to an abnormal epiglottis are presented. We present our approach to the dia gnosis using fibre-optic examination of the hypopharynx, and our treat ment using endoscopic carbon dioxide laser partial epiglottidectomy. W e found in our series that in 11.5 per cent of patients who failed the uvulopalatopharyngoplasty procedure, the reason was a narrow airway a t the hypopharyngeal level caused by an abnormal epiglottis. It is our suggestion that in these cases a laser partial epiglottidectomy shoul d be performed. The results of this study show that partial epiglottid ectomy can increase the cure rate of patients with obstructive sleep a pnoea syndrome by 10-15 per cent.