Severe snoring, repeated breath-holding, choking spells during sleep, and significant sleep disturbance and excessive daytime sleepiness led to the diagnosis of severe obstructive sleep apnea (OSA) (a condition where the airway repeatedly gets blocked during sleep) in a 26-year-old marine engineer, Vikas Gupta (name changed), at Manipal Hospital Broadway, KolkataA previous polysomnography (detailed sleep study) had recorded an Apnoea-Hypopnoea Index (AHI) (the number of times breathing stops or becomes very shallow per hour) of over 40, along with a significant drop in blood oxygen levelsThe patient was referred to DrDipankar Datta, Senior Consultant- ENT and Sleep Apnea Surgeon, Manipal Hospital, BroadwayAs he was non-obese and did not wish to depend on CPAP (a machine that keeps the airway open with continuous air pressure during sleep) for long-term treatment, a targeted multi-level surgery was chosen as the best option.
Before surgery, an advanced test called Drug-Induced Sleep Endoscopy (DISE) (a test that shows where the airway gets blocked during sleep) was performedIt showed blockages at multiple levels, including nasopharynx(junction of nose and throat), the palate (soft tissue at the back of the mouth) and throatThe patient also had a deviated nasal septum (a bent partition inside the nose), while the tongue caused only minor blockageBased on these findings, the team performed a targeted, minimally invasive surgery involving septoplasty (straightening the nasal septum) and Barbed Palatopharyngoplasty(reshaping and supporting the palate and throat to improve airflow using special barbed sutures)The procedure used endoscopic and microscopic assistance with a coblation technique (Bloodless and painless technique using Plasma energy)By treating the specific areas causing the blockage, the surgery improved the patient’s airway without extensive removal of the palate or uvula (the small hanging tissue at the back of the mouth)Following the surgery, the patient showed good recovery with significant relief from his symptoms and within two days.
Speaking about the case, DrDipankar Datta stated, “This was an unusual case as the patient was only 26 years old and non-obeseSince his profession as a marine engineer requires good-quality sleep and alertness, it was important to find a definitive solutionSleep endoscopy helped us identify exactly where his airway was collapsing during sleep, particularly at the level of the palate and oropharynxBased on these findings, we performed a targeted multi-level surgery involving septoplasty and Barbed PalatopharyngoplastyThe patient has recovered well, and we are hopeful that he will be able to resume his professional duties after completing his recovery.”
Sharing his experience, Vikas Gupta (name changed) said, “The constant snoring, disturbed sleep and choking episodes had started affecting my daily life and were also becoming a concern for my workAs a marine engineer, getting proper sleep and being alert are extremely important for meI was initially worried about undergoing surgery, but Dr Datta and his team explained the problem and the treatment clearlyI am feeling much better after the procedure, my sleep is much better now and am hopeful that I will be able to return to my duties soon.”
The patient has recovered well following the surgery and has been dischargedHe will gradually return to a soft and normal diet over the next few days and has reported that his sleep has significantly improved following the procedureAs part of his recovery, he plans to resume his professional duties as a marine engineer on his next shipment, subject to medical clearanceHe has also been advised to remain in follow-up with the medical team when he returns to Kolkata.
About Manipal Hospitals:
Manipal Hospitals is one of India’s leading integrated healthcare providers serving ~ 8 million patients annually, focussed on providing accessible, high-quality healthcare servicesManipal’s integrated network today has a pan-India footprint of 50 hospitals with over 13,400 licensed beds across 14 States & Union TerritoriesThe network is India’s largest multispecialty hospital network by bed capacity, supported by a talented pool of 11,000+ doctors and an employee strength of over 25,000With a commitment to provide patient-centric care, Manipal Hospitals combines clinical expertise with advanced technology, research and innovation to serve a multitude of patients across the globeIts continued focus on clinical quality and operational excellence is reflected in its NABH accreditation, with several of its hospitals also accredited by NABL and recognised for its excellence in nursing and emergency care.
