Clin Exp Otorhinolaryngol.  2022 Nov;15(4):346-353. 10.21053/ceo.2022.00563.

Therapeutic Effect of Multilevel Surgery on Laryngopharyngeal Reflux in Obstructive Sleep Apnea Patients: Impact on the Reflux Symptom Index and Reflux Finding Score

• Song B
• Jung YG
• Hong SD
• Lee EK
• Kim BK
• Park SI
• Jung SH
• Ryu G
• Kim HY

• KMID: 2536533
• DOI: http://doi.org/10.21053/ceo.2022.00563

Abstract

Objectives
. Our previous study found that multilevel obstructive sleep apnea (OSA) surgery mitigated laryngopharyngeal reflux (LPR) symptoms in terms of the reflux symptom index (RSI), but no studies have investigated the impact of OSA surgery on laryngoscopic parameters. The aim of this study was to examine the clinical outcome of LPR improvement following OSA surgery, with a focus on both the RSI and the reflux finding score (RFS).
Methods
. Prospectively collected data from 28 patients who underwent multilevel OSA surgery from 2017 to 2021 were retrospectively analyzed. Patients were asked to complete the RSI questionnaire and underwent a laryngoscopic examination to evaluate the RFS before and after surgery. Age, height, weight, body mass index (BMI), and polysomnography data before and after surgery were also reviewed.
Results
. After surgery, the total RSI and RFS decreased significantly from 11.96±8.40 to 7.68±6.82 (P=0.003) and from 6.57±3.49 to 3.21±1.87 (P<0.001). The positive rates of RSI and RFS decreased from 28.6% to 17.9% and 32.1% to 0%, respectively. Significant improvements were found in the RSI subdomains of throat clearing, throat mucus, breathing difficulty, troublesome cough, and heartburn sensation, while all RFS subdomains except granuloma improved significantly. In subgroup analyses, no significant differences were found between subgroups based on age, OSA severity, or BMI.
Conclusion
. OSA surgery has the potential to alleviate both LPR symptoms and laryngoscopic results. Additional research integrating more objective techniques and novel treatment strategies is required to better comprehend the clinical impact of OSA surgery on LPR.

Keyword

Laryngopharyngeal Reflux; Obstructive Sleep Apnea; Surgery

Figure

• 

  Fig. 1. Comparison of the total reflux symptom index (RSI) and reflux finding score (RFS) before and after obstructive sleep apnea surgery. (A) Statistically significant differences in both the total RSI and RFS. (B) Individual total RSI (B1) and RFS (B2) values before and after surgery. Values are presented as mean±standard deviation.

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