A case of post-tonsillectomy nasopharyngeal stenosis that was repaired using CWICKs

Tonsillectomy is among the most commonly performed surgical procedures in otorhinolaryngology. It causes various complications, such as postoperative hemorrhage, and rarely nasopharyngeal stenosis. We here report a case in which CWICKs, a soft tissue surgical procedure for obstructive sleep apnea, was performed to repair post-tonsillectomy nasopharyngeal stenosis. The patient was a 57-year-old woman with chief concerns about nasal respiratory insufficiency and snoring. She underwent tonsillectomy at another hospital when she was 10 years old. After surgery, she developed severe nasal obstruction and could not breathe through the nose at all in the decubitus position. She was subsequently diagnosed with nasopharyngeal stenosis. Upon referral to our hospital, airway stenosis was detected at the soft palate level. As this was deemed to cause her chief concerns, pharyngoplasty using CWICKs was performed, which alleviated her symptoms and allowed nasal breathing. Because sleep apnea, mainly comprising hypopnea, persisted, treatment with nasal continuous positive airway pressure (n-CPAP) was initiated. With her improved nasal breathing, she was able to wear the n-CPAP mask and adhered to treatment. Currently, the patient is being followed-up at the outpatient clinic of our department. CWICKs appears to be a useful repair procedure for post-tonsillectomy nasopharyngeal stenosis.