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A middle-aged man with history of squamous cell cancer of the base of the tongue, who was treated with chemoradiation and neck dissection 5 years ago, presented with loud snoring, gasping arousals at night and excessive daytime sleepiness with an Epworth Sleepiness Score of 15. He denied any diurnal respiratory symptoms. Routine follow-up since completion of cancer treatment revealed no evidence of disease recurrence and stable mild supraglottic oedema on laryngoscopic evaluation. Physical examination revealed a body mass index of 28.9 kg/m2, Mallampati II airway, firmness on the right side of his neck secondary to prior radiation therapy, no stridor and clear lung fields. A split-night diagnostic-titration study was performed and revealed severe obstructive sleep apnoea (OSA) with an oxygen saturation nadir of 50% (figure 1). Despite …
Contributors All authors contributed to the conception and design, acquisition of radiological and pathological data, drafting the article, critical revision of intellectual content and final approval of the version to be published.
Funding This study was funded by NIH Clinical Center Grant Number CA016672.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.