Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea

Oliveira, Luciana Almeida Moreira da Paz; Fontes, Luiz Henrique de Souza; Cahali, Michel Burihan

doi:10.1016/j.bjorl.2015.03.006

Cited by 16 publications

(20 citation statements)

References 40 publications

(52 reference statements)

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“…These results demonstrate that OSAS impair pharyngeal sensibility, increasing the chance of premature leakage, regardless to OSAS severity. This result is in agreement with previous publications …”

Section: Discussionsupporting

confidence: 94%

“…Both cases belonged to most severe cases among OSAS group. Other authors have also observed laryngeal penetration in patients with OSAS, with prevalence ranging from 5% to 35% . In some of these studies, the prevalence of laryngeal penetration was not related to OSAS severity …”

Section: Discussionmentioning

confidence: 88%

“…Recent studies show that patients with OSAS have sub‐clinical swallowing changes, such as premature loss of food to the hypopharynx, pharyngeal stasis and laryngeal penetration . Laryngotracheal aspiration has also been reported in OSAS .…”

Section: Introductionmentioning

confidence: 99%

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Cephalometric, muscular and swallowing changes in patients with OSAS

Valarelli

Corradi

Grechi

et al. 2018

J of Oral Rehabilitation

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Obstructive Sleep Apnoea Syndrome (OSAS) is believed to be associated with craniofacial and neuromuscular changes, although the interplay among these variables still is poorly recognised. The objective of this study was to identify hyoid, muscular and swallowing changes associated with OSAS, and to correlate these alterations with OSAS severity. Cross-sectional study, in a tertiary referral centre. Seventy-two adult individuals participated in this study: 12 controls (without apnoea) and 60 patients with apnoea (mild, moderate and severe OSAS-20 individuals in each group). All participants were initially evaluated by otorhinolaryngologist and neurologist and underwent polysomnography for OSAS stratification. Cephalometric data, clinical myofunctional status and swallow videofluoroscopy exam were assessed. A hybrid effect model was used to analyse swallowing parameters; dependent variables were age, body mass index (BMI) and cephalometric measures. Individuals with OSAS presented lower hyoid position and narrower posterior airway distance when compared to controls. These parameters correlated to OSAS severity. Additionally, OSAS patients exhibited significantly lower myofunctional scores. Both velum and hyoid contraction times were significantly lower in the OSAS group at videofluoroscopy, regardless of its severity. Premature leakage into pharynx was more common in OSAS groups. Laryngeal penetration phenomenon occurred only in two patients (both from OSAS group). Our results suggest that hyoid bone position is associated with OSAS severity. Muscular pattern and swallowing are impaired in OSAS patients, irrespective of OSAS severity and facial profile. These findings indicate a higher predisposition of OSAS patients to present an inferior hyoid positioning, accompanied by myofunctional and swallowing disorders.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 88%

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Cephalometric, muscular and swallowing changes in patients with OSAS

Valarelli

Corradi

Grechi

et al. 2018

J of Oral Rehabilitation

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“…This may be related to the use of compensatory maneuvers during swallowing, given that backward movement of the head was observed in 61.18% of participants as an attempt to improve the mobility of the oropharyngeal region, mobilize the food, and compensate for the swallowing alterations . Similar compensatory maneuvers were observed in another study that evaluated deglutition in mouth‐breathing children with hypertrophy of the tonsils …”

Section: Discussionmentioning

confidence: 54%

“…29 Similar compensatory maneuvers were observed in another study that evaluated deglutition in mouth-breathing children with hypertrophy of the tonsils. 30 Analysis of DOSS and the Classification for Severity of Dysphagia to Videofluoroscopy Scale revealed that more than half of our studied population recorded mild alterations to deglutition (51.69% and 74% respectively). This difference may be attributed to the inclusion of motor control criteria.…”

Section: Discussionmentioning

confidence: 87%

Swallowing patterns after adenotonsillectomy in children

Branco

Corrêa

Neves

et al. 2019

Pediatric Investigation

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Importance Hypertrophy of the pharyngeal and palatine tonsils can interfere with breathing, physical and cognitive development, and quality of life, including sleep quality. There are important relationships between the muscles of the airways, the anatomy, and the pattern of breathing and swallowing. Objective The aims of the present study were to evaluate the swallowing process in children after adenotonsillectomy undertaken to treat obstructive breathing disorders. Methods Subjects were 85 children or adolescents who underwent adenotonsillectomy in a reference hospital between 2003 and 2007. For the clinical evaluation of swallowing, the protocol of orofacial myofunctional evaluation with scores (OMES) was used, videofluoroscopy of deglutition was performed, and the Dysphagia Outcome and Severity Scale (DOSS) and Classification for Severity of Dysphagia to Videofluoroscopy Scale were applied for analysis. Results Out of the 85 evaluated children, 43 were male (50.59%), the average age at evaluation was 12.11 years, the average age at the time of surgery was 6.73 years, and post‐surgery time was 3.00–8.00 years. In the clinical evaluation of swallowing, half the sample (50.59%) recorded the poorest score for lip and tongue behavior. A score of 1 was observed in 67.06% of subjects for other behaviors, and in 15.30% of subjects for efficiency of swallowing. Videofluoroscopic analysis demonstrated that the most frequent swallowing alterations were labial sealing (50.59%), residue in vallecula (51.76%), and use of compensatory maneuvers (61.18%). Analysis of DOSS showed that normal swallowing was attributed to 48.31% of subjects at level 7, 44.95% at level 6, and 6.74% at level 5. For the Classification for Severity of Dysphagia to Videofluoroscopy, 75.28% were classified as having mild dysphagia. Interpretation Alterations in the dynamics of swallowing are common in children who have undergone surgery of the tonsils, even at late follow‐up.

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Swallowing outcome to speech therapy intervention in resistant hypertensive patients with obstructive sleep apnea

Borges

Muniz

Ferreira

et al. 2022

Eur Arch Otorhinolaryngol

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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.

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Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea

Abstract: Pharyngoesophageal manometry detected no statistically significant difference between the groups with and without oropharyngeal dysphagia.

Cited by 16 publications

References 40 publications

Cephalometric, muscular and swallowing changes in patients with OSAS

Cephalometric, muscular and swallowing changes in patients with OSAS

Swallowing patterns after adenotonsillectomy in children

Swallowing outcome to speech therapy intervention in resistant hypertensive patients with obstructive sleep apnea

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