Please use this identifier to cite or link to this item:
|Scopus||Web of Science®||Altmetric|
|Title:||Pathophysiology of swallowing following oropharyngeal surgery for obstructive sleep apnea syndrome|
|Citation:||Neurogastroenterology and Motility, 2018; 30(5):13277-1-13277-11|
|M. Schar, C. Woods, E.H. Ooi, T. Athanasiadis, L. Ferris, M. M. Szczesniak, C. Cock, T. Omari|
|Abstract:||Background: Uvulopalatopharyngoplasty (UPPP) and coblation channeling of the tongue (CCT) are oropharyngeal surgeries used to treat obstructive sleep apnea syndrome. The extent to which UPPP and CCT affect pharyngeal swallow has not been determined. We therefore conducted a novel case series study employing high-resolution impedance manometry (HRIM) to quantify the swallowing-related biomechanics following UPPP and/or CCT surgery. Methods: Twelve patients who underwent UPPP+CCT or CCT only were assessed an average 2.5 years postsurgery. Swallow function data were compared with ten healthy controls. All patients completed the Sydney swallow questionnaire (SSQ). Pharyngeal pressure-flow analysis of HRIM recordings captured key distension, contractility and pressure-flow timing swallow parameters testing 5, 10, and 20 mL volumes of thin and thick fluid consistencies. Key Results: Postoperative patients had more dysphagia symptoms with five returning abnormal SSQ scores. Swallowing was biomechanically altered compared to controls, consistent with diminished swallowing reserve, largely driven by elevated hypopharyngeal intrabolus pressure due to a reduced capacity to open the upper esophageal sphincter to accommodate larger volumes. Conclusions & Inferences: Patients who have undergone UPPP and/or CCT surgery appear to have a deficiency in normal modulation of the swallowing mechanism and a reduced swallowing functional reserve. We speculate that these changes may become relevant in later life with the onset of age-related stressors to the swallowing mechanism. This case series strikes a note of caution that further studies are needed to determine the role of preoperative swallow assessment in patients undergoing UPPP and/or CCT surgery.|
|Keywords:||Dysphagia; high-resolution manometry; impedance; obstructive sleep apnea; swallowing; upper esophageal sphincter|
|Rights:||© 2017 John Wiley & Sons Ltd|
|Appears in Collections:||Aurora harvest 4|
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.