Purpose
To evaluate (i) the outcome of swallowing therapy program on the rehabilitation of oropharyngeal dysphagia in resistant hypertensive patients with obstructive sleep apnea (OSA) and (ii) the association between the clinical and anthropometric characteristics of these individuals and this outcome.
Methods
This was a prospective interventional study in which resistant hypertensives diagnosed with OSA by polysomnography and dysphagia by fiberoptic endoscopic evaluation of swallowing (FESS) participated. All participants underwent a FEES and assessment of the risk of dysphagia (Eating Assessment Tool, EAT-10) and swallowing-related quality of life (Swal–QoL) before and after the intervention. The therapeutic program was performed daily by the participants, with weekly speech-therapist supervision for eight weeks, including the following strategies: Masako, chin tuck against resistance, and expiratory muscle training.
Results
A total of 26 (78.8%) of the participants exhibited improvement in the degree of dysphagia in the intervention outcome. After the intervention, there was a statistically significant improvement in the level of penetration–aspiration (
p
= 0.007), the degree of pharyngeal residue (
p
= 0.001), the site of onset of the pharyngeal phase (
p
= 0.001), and the severity of dysphagia (
p
= 0.001) compared to before intervention. The EAT-10 score was 2 (0–6) before and 0 (0–3) after intervention (
p
= 0.023). Swal–QoL had a score on the symptom frequency domain of 92.8 (75–100) before and 98.2 (87.5–100) after intervention (
p
= 0.002).
Conclusions
Resistant hypertensive patients with OSA showed improved swallowing performance after swallowing therapy program.
Supplementary Information
The online version contains supplementary material available at 10.1007/s00405-022-07612-3.
Purpose: to evaluate the relationship between acoustic analysis of swallowing sounds and the presence of pharyngeal residue and penetration/aspiration detected by fiberoptic endoscopic evaluation of swallowing in resistant hypertensive patients with obstructive sleep apnea. Methods: an observational study in which resistant hypertensive individuals diagnosed with obstructive sleep apnea participated through the all-night polysomnography exam. The participants underwent an acoustic analysis of swallowing sounds, using a Doppler sonar and simultaneously a fiberoptic endoscopic evaluation of swallowing. The acoustic parameters analyzed were initial frequency, initial intensity, first peak frequency, second peak frequency, final intensity and swallowing time. Independent samples of t-test and Mann-Whitney test were used for statistical analysis. The level of statistical significance adopted was 5%. Results: eighty five participants with average age of 58.3±6.3 years were evaluated. There was a statistically significant difference between groups with and without pharyngeal residue, in relation to the following parameters of swallowing acoustic signal: initial frequency and intensity, second peak frequency, final intensity and swallowing time. Only 10 milliliters of pudding consistency showed a statistically significant difference in the second peak frequency of the acoustic signal of swallowing between groups with and without penetration/aspiration. Conclusion: a relationship between measurements of swallowing acoustic signal and pharyngeal residue in this population was found, but not between swallowing sounds and penetration/aspiration.
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