Eesa Mohamed, Montevecchi Filippo, Hendawy Ehsan, D'Agostino Giovanni, Meccariello Giuseppe, Vicini Claudio
Department of Otolaryngology, Head-Neck Surgery, University of Zagazig, Zagazig, Egypt,
Eur Arch Otorhinolaryngol. 2015 Jun;272(6):1537-41. doi: 10.1007/s00405-014-3480-x. Epub 2015 Jan 4.
The aim of this study was to evaluate outcomes related to swallowing function in patients who underwent transoral robotic surgery (TORS) for sleep apnea on both short- and long-term scales. 78 patients who underwent TORS for sleep apnea between 2011 and 2014 were followed up for an average period of 20 ± 7.12 months (range 7-32 months), then swallowing outcomes determined by MD Anderson Dysphagia Inventory (MDADI) questionnaire, gastrografin fluoroscopy imaging results, nasogastric tube dependence and subjectively by recording the patients' complaints were analyzed and reported. Minimal insignificant short-term impact on swallowing function (4.58 ± 7.03 preoperative MDADI score versus 5.18 ± 8.32 post-operative) (p = 0.56) was registered. Mean time for start of oral feeding was 1.05 ± 0.25 days (average, 1-3). In no case nasogastric tube feeding was required. Only five patients (6 %) showed significant aspiration on gastrografin fluoroscopy examination after 1 week; there was no significant correlation between the volume of tissue removed from both tongue base and epiglottis to the incidence of aspiration as shown by gastrografin fluoroscopy examination (p = 0.72). No long-term swallowing complaint was registered. Patients who underwent TORS tongue base reduction and supraglottoplasty for sleep apnea proved to have a reasonable short-term swallowing outcomes with no long-term sequelae.
本研究的目的是在短期和长期范围内评估接受经口机器人手术（TORS）治疗睡眠呼吸暂停的患者的吞咽功能相关结果。对2011年至2014年间接受TORS治疗睡眠呼吸暂停的78例患者进行了平均20±7.12个月（范围7 - 32个月）的随访，然后通过MD安德森吞咽障碍量表（MDADI）问卷、泛影葡胺透视成像结果、鼻胃管依赖情况以及记录患者主诉进行主观评估来确定吞咽结果，并进行分析和报告。记录到吞咽功能受到的短期影响极小且无统计学意义（术前MDADI评分为4.58±7.03，术后为5.18±8.32）（p = 0.56）。开始经口进食的平均时间为1.05±0.25天（平均，1 - 3天）。无一例需要鼻胃管喂养。仅5例患者（6%）在1周后的泛影葡胺透视检查中出现明显误吸；泛影葡胺透视检查显示，舌根和会厌切除组织的量与误吸发生率之间无显著相关性（p = 0.72）。未记录到长期吞咽问题。接受TORS治疗舌根缩小和声门上成形术治疗睡眠呼吸暂停的患者在短期内吞咽结果良好，且无长期后遗症。
