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Case Reports in Otolaryngology
Volume 2018, Article ID 4798024, 4 pages
Case Report

Combined Surgical Approach for Obstructive Sleep Apnea Patient

1Al-Sabah Hospital, Ministry of Health, Kuwait City, Kuwait
2Department of Surgery Health, Medical Clinic Dammam, Saudi Arabia
3ENT Clinic, Dasman Diabetes Institute, Kuwait City, Kuwait

Correspondence should be addressed to Abdulmohsen E. Al-Terki; moc.liamtoh@tne8q

Received 10 October 2017; Accepted 2 January 2018; Published 28 March 2018

Academic Editor: Dinesh K. Chhetri

Copyright © 2018 Mahmoud A. K. Ebrahim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Obstructive sleep apnea (OSA) is a disease that is associated with high morbidity and mortality and can significantly impact the quality of life in a patient. OSA is strongly associated with obesity, and literature showed that weight loss will lead to improvement in OSA. The gold standard treatment for OSA is continuous positive airway pressure (CPAP). However, other methods of treatment are available. One of these methods is multilevel sleep surgery (MLS). Literature showed that bariatric surgery can also improve OSA. A common question is which surgical procedure of these two should be performed first. We present a 5-year follow-up of a patient who underwent simultaneously bariatric surgery and MLS. His apnea-hypopnea index (AHI) decreased from 53 episodes per hour to 5.2 per hour within the first 18 months, which was measured via a level 3 polysomnography. Five years after the surgery, a repeat level 3 polysomnography showed an AHI of 6.8 episodes per hour, and the patient is asymptomatic. The patient maintained his weight and did not use CPAP after the combined surgery during the five-year period.