Nasopharyngeal Masses Presenting as Obstructive Sleep Apnea Syndrome

Abstract

We present two unusual cases of obstructive sleep apnea (OSA) secondary to isolated nasopharyngeal pathology. The syndrome of OSA has become more prevalent over the past two decades. Pathologic conditions that may cause OSA can occur throughout the upper airway from the nose to the larynx. In the vast majority of patients such discrete lesions are not found, but rather a combination of disproportionate anatomical relationships is found to facilitate airway collapse. Review of the literature reveals only rare cases of isolated nasopharyngeal lesions causing polysomnographically documented OSA. We present two cases of nasopharyngeal masses, a squamous cell carcinoma and a hamartoma, which presented as OSA. Although a variable amount of airway obstruction exists in most patients with nasopharyngeal masses, we report the only known case of OSA secondary to a nasopharyngeal hamartoma. Such reports underscore the importance of a thorough head and neck examination in patients presenting with OSA.