No Persistent Postoperative Swallowing Dysfunction Following Pharyngeal Surgery in Patients with Obstructive Sleep Apnea

by Linda Kossoff •

How does swallowing dysfunction manifest in patients undergoing upper airway surgery for obstructive sleep apnea (OSA)?

BOTTOM LINE

Pharyngeal surgery resulted in no significant, persistent adverse change in swallowing function in patients.

BACKGROUND: Upper airway surgery is indicated for patients with OSA when conservative therapies have failed to control the disorder. Transient postoperative swallowing dysfunction is commonly quoted as a risk of OSA surgery; however, there are limited data regarding identification, evaluation, and management of postoperative swallowing dysfunction in this patient population.

STUDY DESIGN: Retrospective analysis.

SETTING: Section of Otolaryngology–Head and Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Canada.

SYNOPSIS: Researchers conducted a retrospective chart review of data prospectively collected between January 2017 and February 2020 of patients at a tertiary sleep surgery center who had failed a trial of continuous positive airway pressure for OSA. The 100 patients were divided into two surgical groups based on the Stanford Sleep Surgery Protocol: Phase 1 reconstructive surgery (for moderate-to-severe OSA, 41 patients) and Mini-Phase 1 surgery (for mild OSA, 59 patients). All patients underwent uvulopalatopharyngoplasty with tonsillectomy (where applicable). The Eating Assessment Tool (EAT-10) was used to evaluate patients for potential symptoms of dysphagia preoperatively and at one, three, and six months postoperatively. No significant differences were found between Phase 1 and Mini-Phase 1 patients in preoperative swallowing function. Both groups experienced significant subjective dysphagia at one month postoperatively, greater among Phase 1 than Mini-Phase 1 patients. Swallowing function in both groups normalized by three and six months postoperatively. Phase 1 patients reported improved swallowing versus preoperative levels by six months postoperatively. Study limitations included the lack of accounting for any concurrent conservative interventions during the study period.

CITATION: Rasool A, Randall DR, Chau JKM, et al. Functional outcomes of swallowing following surgery for obstructive sleep apnea. Laryngoscope. 2023;133:199-204.