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Severe sleep disordered breathing in head and neck cancer survivor
  1. Sonam Jaggi1,
  2. Diwakar D Balachandran2,
  3. Lara Bashoura2,
  4. Saadia A Faiz2
  1. 1 Divisions of Pulmonary, Critical Care Medicine and Sleep Medicine, McGovern Medical School at University of Texas Health, Houston, Texas, USA
  2. 2 Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
  1. Correspondence to Dr Saadia A Faiz, Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX 77030-1402, USA; safaiz{at}mdanderson.org

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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 …

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