Song Bokhyun, Jung Yong Gi, Hong Sang Duk, Lee Eun Kyu, Kim Byung Kil, Park Song I, Jung Sung Ha, Ryu Gwanghui, Kim Hyo Yeol
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Clin Exp Otorhinolaryngol. 2022 Nov;15(4):346-353. doi: 10.21053/ceo.2022.00563. Epub 2022 Jul 15.
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).
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.
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.
OSA surgery has the potential to alleviate both LPR symptoms and laryngoscopic.
Additional research integrating more objective techniques and novel treatment strategies is required to better comprehend the clinical impact of OSA surgery on LPR.
我们之前的研究发现，多级阻塞性睡眠呼吸暂停（OSA）手术在反流症状指数（RSI）方面减轻了喉咽反流（LPR）症状，但尚无研究调查OSA手术对喉镜检查参数的影响。本研究的目的是检查OSA手术后LPR改善的临床结果，重点关注RSI和反流发现评分（RFS）。
回顾性分析了2017年至2021年接受多级OSA手术的28例患者的前瞻性收集数据。患者被要求完成RSI问卷，并在手术前后接受喉镜检查以评估RFS。还回顾了手术前后的年龄、身高、体重、体重指数（BMI）和多导睡眠图数据。
手术后，总RSI和RFS显著降低，从11.96±8.40降至7.68±6.82（P=0.003），从6.57±3.49降至3.21±1.87（P<0.001）。RSI和RFS的阳性率分别从28.6%降至17.9%和从32.1%降至0%。在清嗓、咽喉黏液、呼吸困难、烦人的咳嗽和烧心感的RSI子域中发现了显著改善，而除肉芽肿外的所有RFS子域均有显著改善。在亚组分析中，基于年龄、OSA严重程度或BMI的亚组之间未发现显著差异。
OSA手术有可能减轻LPR症状和喉镜检查结果。
需要整合更多客观技术和新治疗策略的进一步研究，以更好地理解OSA手术对LPR的临床影响。
