Koji Kanayama, Koichi Toyoshima, Jun Takami, Hiroki Mori, Mutsumi Okazaki
Multiple symmetric lipomatosis can cause extraluminal upper-airway compression and aggravate obstructive sleep apnea (OSA). The authors report a 60-year-old man with severe OSA and marked anterior cervical lipomatosis who had persistent residual respiratory events despite adherent use of continuous positive airway pressure (CPAP) therapy. Anterior cervical lipectomy for neck contouring was performed, removing 2552 g of lipomatous tissue. Postoperatively, snoring improved and the device-reported residual apnea-hypopnea index decreased from 16.2 to 6.9 events/hours at 3 months and to 2.3 events/hours after CPAP reinitiation at 3 years 5 months. Anterior cervical lipectomy may improve CPAP responsiveness in selected patients with neck lipomatosis and prominent cervical airway compression.