Section: 
General questions of otolaryngology
General questions of otolaryngologyUnusual contraindications for cpap therapy in patient with psoriatic spondylosis
I. G. Arustamyan (1), P. Yu. Kudinov (2), S. R. Tagieva (3)
(1) Saint Petersburg Research Institute of Ear, Throat, Nose, and Speech, Saint Petersburg, 190013, Russian Federation, (1), (2), (3) Autonomous Non-Profit Organization „Medical Center ‘21st Century“, 194044, Russian Federation
UDK: УДК 616.711-002+615.284.2-085-035.2
DOI: https://doi.org/10.18692/1810-4800-2025-6-8-13
ABSTRACT
Abstract. The article describes a clinical case of a patient with obstructive sleep apnea syndrome (OSA) and psoriatic spondylosis (a chronic inflammatory disease of the spine), in which continuous positive airway pressure (CPAP) therapy was impossible due to anatomical changes in the cervical spine. The patient underwent comprehensive diagnostics, including polysomnography, sleep endoscopy, CT of the paranasal sinuses, and MRI of the cervical spine, consultations with an ENT specialist and a sleep specialist. A trial course of CPAP therapy, initially proposed as treatment, caused severe throat pain, likely due to pharyngeal changes associated with cervical osteophytes. Alternative treatment methods offered to the patient included positional therapy, a hypoallergenic environment, weight loss, septoplasty with inferior turbinate reduction, and the use of oral devices. This case highlights a unique combination of two conditions — psoriatic spondylosis and OSA. Patients with structural deformations of the pharynx should be considered a risk group for CPAP therapy. It is important to note that thorough diagnostics, including MRI of the cervical spine, and a multidisciplinary approach can significantly improve the effectiveness of therapy in this patient group.
Publication date:
23.12.2025
Keywords:
psoriatic spondylosis, snoring, obstructive sleep apnea syndrome, CPAP therapy, sleep endoscopy For citation:
Arustamyan I. G., Kudinov P. Yu., Tagieva S. R. Unusual contraindications for cpap therapy in patient with psoriatic spondylosis. Russian Otorhinolaryngology. 2025;24(6):8-13. (In Russ.) https://doi.org/10.18692/1810-4800-2025-6-8-13