This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
To the Editor.—
I have read the article "Adverse Effects of Tracheostomy for Sleep Apnea" by Conway et al (1981;246:347). The authors present 11 cases of hypersomnia sleep apnea of obstructive etiology that were treated by tracheostomy. For the most part, their results show dramatic improvement of the manifestations of sleep apnea, but an entire new set of complications ensued, including tracheal complications, infection, and psychosocial difficulties.It has been documented that the upper airway obstruction seen in these patients is sometimes secondary to either a congenital or acquired mandibular retrognathia. The authors list two patients of the 11 in their Table 1 (p 348) with a diagnosis of mandibular retrognathia as the primary underlying disease of these patients' airway obstruction.We believe that an orthognathic evaluation to include cephalometric analysis, model surgery, and postural positioning of the mandible for airway assessment should be accomplished on all patients with hypersomnia
Berger RM. Mandibular Retrognathia and Sleep Apnea. JAMA. 1982;247(16):2234. doi:10.1001/jama.1982.03320410020018
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: