Department of Otorhinolaryngology, Hospital Prof. Doutor Fernando Fonseca, Lisbon, Portugal.
Department of Otorhinolaryngology, Hospital Prof. Doutor Fernando Fonseca, Lisbon, Portugal.
Auris Nasus Larynx. 2023 Dec;50(6):921-928. doi: 10.1016/j.anl.2023.02.004. Epub 2023 Mar 9.
To evaluate swallowing in patients who underwent CO2 LASER Partial Epiglottectomy (CO2-LPE) for Obstructive Sleep Apnea Syndrome and to assess the risk of aspiration with this technique.
MATERIAL & METHODS: Chart review of adult patients who underwent CO2-LPE between 2016 and 2020, in a secondary care hospital. Patients underwent surgery for OSAS, in accordance to Drug Induced Sleep Endoscopy findings and an objective swallowing evaluation was done at least 6 months after surgery. Eating Assessment Tool (EAT-10) questionnaire was applied and Volume-Viscosity Swallow Test (V-VST) and Fiberoptic Endoscopic Evaluation of Swallowing (FEES) were performed. Dysphagia was classified according to Dysphagia Outcome Severity Scale (DOSS).
Eight patients were included in the study. The mean time between surgery and the swallowing evaluation was 50 (±13,2) months. Only 3 patients presented ≥ 3 points on EAT-10 questionnaire. Two patients presented signs of decreased efficacy of swallowing (piecemeal deglutition) but none had a decrease in safety, according to V-VST. Although 50% of the patients presented some pharyngeal residue on FEES, it was classified as trace to mild in most of the cases. No evidence of penetration or aspiration was identified (DOSS ≥ 6 in all patients).
The CO2-LPE is a potential treatment for OSAS patients with epiglottic collapse and no evidence of swallowing safety compromise was found.
评估接受 CO2 激光部分杓状软骨切除术（CO2-LPE）治疗阻塞性睡眠呼吸暂停综合征（OSAS）患者的吞咽情况，并评估该技术发生误吸的风险。
回顾性分析 2016 年至 2020 年期间在一家二级保健医院接受 CO2-LPE 的成年患者的病历。根据药物诱导睡眠内镜检查结果，对这些患者行手术治疗 OSAS，术后至少 6 个月进行客观吞咽评估。应用饮食评估工具（EAT-10）问卷进行评估，并进行容积粘度吞咽测试（V-VST）和纤维光学吞咽评估（FEES）。根据吞咽障碍严重程度量表（DOSS）对吞咽障碍进行分类。
本研究共纳入 8 例患者。手术与吞咽评估之间的平均时间为 50（±13.2）个月。只有 3 例患者的 EAT-10 问卷得分≥3 分。根据 V-VST，2 例患者出现吞咽效果下降（吞咽分段）的迹象，但无 1 例患者吞咽安全性下降。尽管 50%的患者在 FEES 上存在一些咽部残留物，但大多数情况下被归类为微量至轻度。所有患者的 DOSS 均<6，未发现有渗透或误吸的证据。
CO2-LPE 是治疗杓状软骨塌陷的 OSAS 患者的一种潜在方法，未发现吞咽安全性受损的证据。
