Publication:

Retropharyngeal lipoma as a treatable cause of severe obstructive sleep apnea in a middle-aged male

Authors present the rare case of a 38-year-old male with severe obstructive sleep apnea (OSA) caused by a large retropharyngeal lipoma. The patient, previously reliant on continuous positive airway pressure (CPAP) therapy for over eight years, presented with persistent snoring, daytime fatigue and a posterior pharyngeal bulge on clinical examination. Imaging confirmed a retropharyngeal lipoma compressing the airway, extending from the clivus to C6 vertebra. A combined transoral and transcervical surgical excision was performed, achieving complete tumor removal and resolution of OSA symptoms. Postoperative recovery was uneventful, with no recurrence or further need for CPAP. This case underscores the importance of thorough evaluation and imaging in patients with unexplained OSA to identify rare causes such as deep neck space lipomas. Surgical excision remains the definitive treatment, offering excellent outcomes and significantly improving quality of life.