Obstructive sleep apnea in elderly patients after closure of tracheostomy

Background and objectives: The closure of tracheostomies may postoperativel y induce an obstructive sleep apnea (OSA) even in patients who never compla ined about sleep related breathing disorders before they underwent tracheot omy. The present study was designed to evaluate, whether OSA appears after the tracheostomy has been airtightly blocked and if so, whether there are t ypical illnesses predictive for OSA after operative closure of tracheostomi es. Patients and Methods: Twelve consecutive patients (3 male; 9 female; mean a ge 66 years), who addressed our clinic for operative closure of their trach eostomies were enrolled in this study over a period of 18 months. On basis of patient's history and clinical findings the patients were divided into t wo groups. Group A included 7 patients with laryngeal pathologies and group B included 5 patients with normal larynges. All patients underwent a 12-ch annel-polysomnography (PSC) with airtightly blocked tracheostomies preopera tively. Results: In 5 patients a mild OSA and in one patient a severe OSA was diagn osed by PSG. The patients of group A with laryngeal pathologies were older, had a lower Body-Mass-index (BMI) and a higher Apnea-Hypopnea-Index than p atients of group B (p < 0.05). Conclusion: Laryngeal pathologies in the elderly might facilitate the devel opment of OSA after operative closure of tracheostomies. Based on the resul ts postoperative reevaluation is recommended for all elderly patients with laryngeal abnormalities after operative closure of the tracheostomy.