a 30-year-old male patient with history suggestive of osa was posted for tonsillectomy and septoplasty under general anaesthesia. besides, he gave history of snoring severe enough to disturb the person next door, episodes of airway obstruction, probable hypopnoea during sleep and daytime somnolence. after a thorough preoperative assessment, confirmation of nbm (nil by mouth) status and written informed consent, the patient was taken up for tonsillectomy under general anaesthesia. the patient was preoxygenated with 100% oxygen for five minutes and induced with gradually increasing concentration of sevoflurane up to 8% with 100% oxygen.
postoperatively, the patient was kept in right lateral position with oxygen by ventimask and nasopharyngeal airway in situ. he complained of daytime fatigue and had a neck circumference of 41cm. [8,9] however as our patient was not on home cpap and was posted for tonsillar resection as a mode of correction, we kept it as an option postoperatively. thus a case of severe osa was managed successfully after thorough understanding of the possible perioperative problems and taking care of all the challenges faced therein.
massively enlarged tonsils can cause episodes of cessation of breathing known as obstructive sleep apnea. cessation of breathing can last 10 seconds or obstructive sleep apnea is when a child briefly stops breathing while sleeping. the most common cause is large tonsils and adenoids in the upper airway. loud swollen tonsils are more likely to cause sleep apnea in kids than adults. 79% of children with sleep apnea have their symptoms resolved through a tonsillectomy., .
just like in children, adults with enlarged tonsils also do better after sleep apnea surgery that includes tonsillectomy. one reason seems to be tonsillectomy with adenoidectomy is a combination surgery that has been used to treat pediatric obstructive sleep apnea (osa). obstructive sleep apnoea (osa) is a disorder characterised by repeated disruption of breathing during sleep. sleep apnoea is more common in males, obese,[1,2], .
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