How does swallowing dysfunction manifest in patients undergoing upper airway surgery for obstructive sleep apnea (OSA)?
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January 2023Pharyngeal 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.