An overview on the role of epiglottis in obstructive sleep apnoea

Abstract

Obstructive sleep apnoea (OSA) is common sleep disorder with its multimodal effect on health. OSA, if untreated can lead to various cardiovascular, cerebrovascular, psychological, cognitive as well as sexual morbidities. Continuous positive airway pressure (CPAP) device is considered as the gold standard in the treatment of OSA. Epiglottic collapse (EC) in OSA has evolved an important factor in the management of OSA as the CPAP may worsen the sleep apnoea. EC in itself is classified into primary or secondary, partial or complete, anteroposterior or lateral. Epiglottic collapse is considered as one of the causes for poor adherence to CPAP devices. There are newer diagnostic modalities to diagnose and distinguish primary and secondary epiglottic collapse of which interventional drug induced sleep endoscopy plays a viable and important role. CPAP still serves as a primary treatment modality for multilevel OSA with EC. Surgical treatment modalities for EC is aimed at improving the compliance of CPAP as well as for relieving the obstruction. Surgical options primarily include epiglottectomy, glossoepiglottopexy, epiglottis stiffening operations.