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Uvulopalatopharyngoplasty for nasal blockage 21 years after total rhinectomy

Published online by Cambridge University Press:  27 August 2021

J Verdonck ,
E Van de Perck ,
J Claes  and
O M Vanderveken
J Verdonck*
Affiliation:
Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
E Van de Perck
Affiliation:
Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium ENT, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
J Claes
Affiliation:
ENT, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
O M Vanderveken
Affiliation:
Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium ENT, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
*
Author for correspondence: Dr Jan Verdonck, Faculty of Medicine and Health Sciences, University of Antwerp, Prinsstraat 13, 2000 Antwerpen, Belgium E-mail: [email protected]
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Abstract

Background

Total rhinectomy is an invasive procedure that significantly impairs the intranasal turbulence, humidification and heating of inspired air. The use of uvulopalatopharyngoplasty for the treatment of sleep-disordered breathing disorders such as primary snoring and obstructive sleep apnoea has diminished over the past years because of the emergence of less invasive procedures and alternative therapeutic options. This clinical record presents the treatment of a long-term side effect of total rhinectomy using uvulopalatopharyngoplasty.

Case report

In 1997, a 62-year-old male underwent total rhinectomy for a nasal schwannoma, followed by rehabilitation with a nasal prosthesis. Twenty-one years later, he presented with severe complaints of nasal blockage and breathing difficulties during both daytime and night-time. Clinical examination revealed no major anomalies besides significant velopharyngeal narrowing. Thus, in 2019, uvulopalatopharyngoplasty was performed to re-establish velopharyngeal patency. Hereafter, the symptoms of nasal blockage disappeared, resulting in an improved quality of life.

Conclusion

Uvulopalatopharyngoplasty may prove useful to treat selected patients with daytime breathing difficulties due to velopharyngeal narrowing.

Keywords

Airway ObstructionSurgeryTissue AdhesionsPharynxSoft PalateNasal NeoplasmsMaleMiddle Aged
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 10 , October 2021 , pp. 937 - 939
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr J Verdonck takes responsibility for the integrity of the content of the paper

References

Stanley, RJ, Olsen, KD. Rhinectomy for malignant disease. A 20-year experience. Arch Otolaryngol Head Neck Surg 1988;114:1307–11CrossRefGoogle ScholarPubMed
Becker, C, Becker, AM, Dahlem, KKK, Offergeld, C, Pfeiffer, J. Aesthetic and functional outcomes in patients with a nasal prosthesis. Int J Oral Maxillofac Surg 2017;46:1446–50CrossRefGoogle ScholarPubMed
Fujita, S, Conway, W, Zorick, F, Roth, T. Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 1981;89:923–34CrossRefGoogle Scholar
Caples, SM, Rowley, JA, Prinsell, JR, Pallanch, JF, Elamin, MB, Katz, SG et al. Surgical modifications of the upper airway for obstructive sleep apnea in adults: a systematic review and meta-analysis. Sleep 2010;33:1396–407CrossRefGoogle ScholarPubMed
Kezirian, EJ, Weaver, EM, Yueh, B, Deyo, RA, Khuri, SF, Daley, J et al. Incidence of serious complications after uvulopalatopharyngoplasty. Laryngoscope 2004;114:450–3CrossRefGoogle ScholarPubMed
Tang, JA, Salapatas, AM, Bonzelaar, LB, Friedman, M. Long-term incidence of velopharyngeal insufficiency and other sequelae following uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 2017;156:606–10CrossRefGoogle ScholarPubMed
Vicini, C, Hendawy, E, Campanini, A, Eesa, M, Bahgat, A, AlGhamdi, S et al. Barbed reposition pharyngoplasty (BRP) for OSAHS: a feasibility, safety, efficacy and teachability pilot study. “We are on the giant's shoulders”. Eur Arch Otorhinolaryngol 2015;272:3065–70CrossRefGoogle Scholar
Pang, KP, Woodson, BT. Expansion sphincter pharyngoplasty: a new technique for the treatment of obstructive sleep apnea. Otolaryngol Head Neck Surg 2007;137:110–14CrossRefGoogle ScholarPubMed
Li, HY, Lee, LA. Relocation pharyngoplasty for obstructive sleep apnea. Laryngoscope 2009;119:2472–7CrossRefGoogle ScholarPubMed
Weber, O. Presentation of a patient with resection of the lower jaw, the naturhist [in German]. med Vereins z Heidelberg 1845;4:80–2Google Scholar
Ferguson, W. In Operation of the Upper Jaw. Edinburgh: John Churchill, 1842Google Scholar
Coindre, MJ, Trojani, M, Contesso, G, David, M, Rouesse, J, Bui, N et al. Reproducibility of a histopathologic grading system for adult soft tissue sarcoma. Cancer 1986;58:306–93.0.CO;2-7>CrossRefGoogle ScholarPubMed
Stewart, MG, Witsell, DL, Smith, TL, Weaver, EM, Yueh, B, Hannley, MT. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg 2004;130:157–63CrossRefGoogle ScholarPubMed
Harrison, DF. Total rhinectomy--a worthwhile operation? J Laryngol Otol 1982;96:1113–23CrossRefGoogle ScholarPubMed
Chipp, E, Prinsloo, D, Rayatt, S. Rhinectomy for the management of nasal malignancies. J Laryngol Otol 2011;125:1033–7CrossRefGoogle ScholarPubMed
Subramaniam, T, Lennon, P, O'Neill, JP, Kinsella, J, Timon, C. Total rhinectomy, a clinical review of nine cases. Ir J Med Sci 2016;185:757–60CrossRefGoogle ScholarPubMed
Girardi, FM, Hauth, LA, Abentroth, AL. Total rhinectomy for nasal carcinomas. Braz J Otorhinolaryngol 2020;86:763–6CrossRefGoogle ScholarPubMed
Becker, C, Kayser, G, Pfeiffer, J. Squamous cell cancer of the nasal cavity: new insights and implications for diagnosis and treatment. Head Neck 2016;38(suppl 1):E2112–17CrossRefGoogle ScholarPubMed
Miller, TA. Nasal reconstruction. Surg Clin North Am 1986;66:189–200CrossRefGoogle ScholarPubMed
Mendelson, BC, Masson, JK, Arnold, PG, Erich, JB. Flaps used for nasal reconstruction: a perspective based on 180 cases. Mayo Clin Proc 1979;54:91–6Google ScholarPubMed
Cranford, J, Kadakia, S, Berzofsky, C. Palatopharyngoplasty for treatment of nasopharyngeal stenosis secondary to extra-laryngeal tuberculosis. Am J Otolaryngol 2016;37:559–62CrossRefGoogle ScholarPubMed