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Archived Comments for: Small B cell lymphocytic lymphoma presenting as obstructive sleep apnea

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  1. I didn’t see any information about Body Mass Index ( BMI ) and weight loss

    Murat Enoz, Department of Otolaryngology, Head&Neck Surgery Istanbul University, School of Medicine Turkey

    14 April 2005

    Obstructive sleep apnea (OSA) result from sleep-related narrowing of the upper airway, which is thought to be due to varying combinations of anatomical and neuromuscular factors that culminate in an imbalance of forces acting on the airway.

    The goals of the treatment of obstructive sleep apnea (ASA) should be aimed at alleviating symptoms while decreasing morbidity and mortality in a manner thal minimizes side effects.

    In the clinical evaluation of the hypopharynx, indirect laryngoscopy and endoscopy were found to be relatively sensitive tools for predicting obstruction site on the airway (1).

    Indirect laryngoscopy, fibrooptic endoscopy, and cephalometry as easy, inexpensive tools for assessment of the retroglossal region in the pre-surgical evaluation of OSA patients(2). These easy and simple procedures should be conducted for every OSA patient as part of the assessment of the airway. The use of a surgical approach to OSA that uses careful history and examination to identify levels of obstruction followed by systematic surgical intervention at each site is effective for the majority of patients.

    Careful gross examination for asymmetry and clinical findings must be done every patient with obstructive sleep apnea. That is obviates the need for routine microscopic examination of tonsil specimens(3).

    The present patient with severe OSAS because of Respiratory disturbance index (RDI) is 66.0/h. I didn’t see any information about Body Mass Index ( BMI ) and weight loss of patient at the postoperative period. The patient may be need to continuous positive airway pressure (CPAP) at the postoperative period.

    Most hospitals microscopically examine all routine tonsil from healthy patients with recurrent infections or obstructive sleep apnea. This article emphasized that importance of histopathological examination of tonsillectomy specimen.


    1- R.J. Troell, R.W. Riley, N.B. Powell et al., Surgical management of the hypopharyngeal airway in sleep disorder breathing. In: J. Coleman, Editor, Sleep Apnea Pt 1Otolaryngol. Clin. North Am. vol. 31(6), Saunders, Philadelphia (1998), pp. 979–1012.

    2- M. Samir, A. Adly and M. ELShinawy. Tongue base assessment in obstructive sleep apnea. International Congress Series, Volume 1240, October 2003, Pages 753-758.

    3- Michelle D. Williams and Heather M. Brown. The adequacy of gross pathological examination of routine tonsils and adenoids in patients 21 years old and younger. Human Pathology, Volume 34, Issue 10, October 2003, Pages 1053-1057.


    Dr.Murat Enoz

    Competing interests

    None declared