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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery

Indexed/Abstracted in: EMBASE, Scopus




Otorinolaringologia 2002 March;52(1):27-9

language: Italian

Forestier’s disease and obstructive sleep apnea syndrome (OSAS). A case report

Puzzuoli Fantoni A., Costa G., Mazzone A., Barillari U.

Seconda Università degli Studi - Napoli Servizio di Foniatria ed Audiologia


Forestier’s disease, an idiopathic disorders with an unknown etiology that mainly affects men (65%) aged over 50 years old (88%), is characterised by an ossification process that affects the paraspinous connective tissue and anterior longitudinal spinous ligament predominantly in the cervical segment of the vertebral columm. The most accredited pathogenetic hypothesis is that the ossification of the anterior longitudinal ligament may be due to the excess formation of osteophytes, leading to compression of the pharynx and cervical esophagus. Obstructive sleep apnea syndrome is correlated to the shape of VAS, and in particular is provoked by stenosis of the latter following the collapse of the pharyngeal walls. We report a case study presenting an association of Forestier’s disease and sleep respiratory disorders (stage 2 according to Lugaresi’s classification of OSAS), in which the persistent mechanical irritation of the retrolaryngeal area in direct contact with osteophytic formations led to a prolapse of the interarytenoid and periarytenoid mucous which protruded into the laryngeal lumen causing respiratory disturbances when the patient was in a supine position or asleep. The patient was operated in MLDS using a CO2 laser to remove the mucous prolapse of the aryepiglottic folds bilaterally and the interarytenoid mucous, thus resolving the sleep apnea disorders. The follow-up after one year confirmed that this strategy significantly improved the patient’s quality of life, although it has not finally resolved the cause of the disease.

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