Oropharyngeal Dysphagia in Patients with Obstructive Sleep Apnea Syndrome

Abstract

Although previous studies demonstrated that patients with obstructive sleep apnea syndrome (OSAS) may present subclinical manifestations of dysphagia, in not one were different textures and volumes systematically studied. The aim of this study was to analyze the signs and symptoms of oropharyngeal dysphagia using fiberoptic endoscopic evaluation of swallowing (FEES) with boluses of different textures and volumes in a large cohort of patients with OSAS. A total of 72 OSAS patients without symptoms of dysphagia were enrolled. The cohort was divided in two groups: 30 patients with moderate OSAS and 42 patients with severe OSAS. Each patient underwent a FEES examination using 5, 10 and 20 ml of liquids and semisolids, and solids. Spillage, penetration, aspiration, retention, and piecemeal deglutition were considered. The penetration-aspiration scale (PAS), pooling score (PS), and dysphagia outcome and severity scale (DOSS) were used for quantitative analysis. Each patient completed the SWAL-QOL questionnaire. Forty-six patients (64 %) presented spillage, 20 (28 %) piecemeal deglutition, 26 (36 %) penetration, and 30 (44 %) retention. No differences were found in the PAS, PS, and DOSS scores between patients with moderate and severe OSAS. Patients with severe OSAS scored higher General Burden and Food selection subscales of the SWAL-QOL. Depending on the DOSS score, the cohort of patients was divided into those with and those without signs of dysphagia. Patients with signs of dysphagia scored lower in the General Burden and Symptoms subscales of the SWAL-QOL. OSAS patients show signs of swallowing impairment in about half of the population; clinicians involved in the management of these patients should include questions on swallowing when taking the medical history.

Pediatric dysphagia: Is interarytenoid mucosal height significant?

“…Both OSA and dysphagia require adequate muscular tone and coordination, and several studies have found that the presence of OSA can exacerbate dysphagia in some patient populations . OSA was less likely to be present in the patients who had a VFSS as compared to those who did not.…”

Usefulness of dexmedetomidine to prevent emergence agitation in a patient with Krabbe disease: a case report

“…Perioperative respiratory complications following a T&A are relatively common and have been described to occur more frequently in children of younger age [5], and lower body weight was reported to be a risk factor for these complications [6,7]. Additionally, dysphagia associated with poor pharyngeal muscle weakness is a risk factor for aspiration leading to respiratory complications [8]. Our patient thus had a high risk of respiratory complications.…”

“…We did not administer any muscle relaxants for any of our patient's three operations because of the risks of hyperkalemia following succinylcholine in patients with neuromuscular disease and the prolongation effect following the administration of nondepolarizing agents. Case reports of patients with other types of leukodystrophy have shown that rocuronium, vecuronium, and atracurium can be safely used without a prolongation effect [8][9][10]. Thus, if rapid sequence induction and intubation is required in a patient with Krabbe disease, a non-depolarizing muscular agent should be used.…”

Perfil da produção científica da apneia obstrutiva do sono na interface da fonoaudiologia

“…A literature search was performed on the databases Lilacs, PubMed and Scopus, crossing the DeCS/MeSH keywords: "Sleep Apnea, Obstructive" (1), "Speech, Language and Hearing Sciences" (2), "Audiology" (3), "Language" (4), "Voice" (5), "Speech Therapy" (6), "Geriatrics" (7), "Public Health" (8) and "Deglutition Disorders" (9). Aiming at the comprehensive action of Speech-Language Pathology, the following free terms were also employed: Oropharyngeal exercises (10), Occupational Speech-Language Pathology (11), Educational Speech-Language Pathology (12), Neurofunctional Speech-Language Pathology (13).…”

“…For example, it may be associated with hearing aspects, such as reduced amplitude of P300 4 , sensorineural hearing loss 5 and auditory processing disorders in children 6 (AUDIOLOGY); signs of swallowing disorder 7,8 (DYSPHAGIA); association with work accidents 9 (OCCUPATIONAL SPEECH-LANGUAGE PATHOLOGY) and learning and memory alterations 10 (EDUCATIONAL SPEECH-LANGUAGE PATHOLOGY). Individuals with OSA present higher risk of cerebrovascular accident 3 (NEUROFUNCTIONAL SPEECH-LANGUAGE PATHOLOGY), and OSA is more frequent with aging 11 (GERONTOLOGY).…”