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Objectives: To study the impact of thyroid surgery on obstructive sleep apnea syndrome (OSAS) evaluated by the apnea/hypopnea index (AHI) was studied. Secondary objectives were to evaluate the impact on the positional component of OSAS and to highlight possible predictors of improvement of OSAS after thyroidectomy. Methods: Twenty-eight patients with OSAS are included in this monocentric study: they underwent total thyroidectomy ( n = 26) or left loboisthmectomy. Postoperative assessment involves a nocturnal control polysomnography as of 60 days after surgery. Results: The mean age at the time of surgery is 61.3 years (standard deviation ±7.3) and average body mass index is 29.6 kg/m (±7.3). Continuous positive airway pressure (CPAP) treatment is introduced preoperatively in 82 % of patients. The statistical analysis shows a significant decrease of 33 % in postoperative AHI for the total population ( p = 0.001), 77 % in patients under CPAP ( p = 0.05), and 27 % in patients without CPAP ( p = 0.02). CPAP therapy could be released in four patients. Given the limited number of subjects studied, the surgery did not impact on the positional component of the OSAS. Statistical analysis failed to link a predictive factor to AHI reduction. Conclusions: We propose thyroid surgery as an alternative or as a complement to CPAP treatment for the patients with goitre: it allows a significant decrease in postoperative AHI, allowing adaptation of the CPAP treatment downward, or even a release in some cases. These results need to be confirmed on a larger series of patients in a prospective study with standardized criteria for polysomnography and multivariate analysis. [ABSTRACT FROM AUTHOR]

Previous studies, using electron probe microanalysis (EPMA) have shown that several elements are selectively concentrated in the lysosomes of the proximal tubule cells (PTC) of the kidney. In these lysosomes the elements are precipitated as non-soluble phosphate salts, before being eliminated with the urinary flow as submicroscopic particles. However, in these studies, large, sub-toxic doses were administered, and this particular mechanism of “concentration–precipitation–elimination” was not initially considered as a physiological process, but, only as a pathological consequence of the toxic doses. Due to the high sensitivity of secondary ion mass spectrometry (SIMS), images can be obtained representing the distributions of these elements at a concentration several orders of magnitude lower than that required by EPMA.Two elements, aluminum and indium, have been administered in the rats at very low doses. Analytical images were acquired using the University of Chicago scanning ion microprobe, and it has been shown that in a few hours, the lysosomes of the PTC are able to remove these two elements from the extracellular fluid, even when they are at a concentration at the ppm range in the plasma.This mechanism of “concentration–insolubilisation–elimination” can be considered as a physiological process for the two studied elements. [Copyright &y& Elsevier]