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. 2021 Dec 25;7(1):266-273.
doi: 10.1002/lio2.718. eCollection 2022 Feb.

Changes in laryngopharyngeal reflux after uvulopalatopharyngoplasty for obstructive sleep apnea: An observational study

Xiaojun Tang  1 , Qinglai Tang  1 , Shisheng Li  1 , Xinming Yang  1 , Ying Zhang  1 , Shiying Zeng  1 , Peiying Huang  1 , Mengmeng Li  1
Affiliations

Changes in laryngopharyngeal reflux after uvulopalatopharyngoplasty for obstructive sleep apnea: An observational study

Xiaojun Tang et al. Laryngoscope Investig Otolaryngol. .

Abstract

Purpose: To estimate laryngopharyngeal reflux (LPR) changes after uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea (OSA) using the reflux symptom index (RSI) and reflux finding score (RFS) questionnaires.

Methods: A total of 91 participants were recruited and divided into three groups: control (n = 27), OSA mild to moderate (n = 29), and OSA severe (n = 35) groups according to polysomnography. All participants completed the preoperative RSI, and underwent blinded evaluation on videolaryngoscopy using the RFS questionnaire. Thirty-four OSA patients who underwent UPPP surgery completed postoperative polysomnography and questionnaires again after a 6-month follow-up.

Results: The RSI score and RFS were higher in patients with OSA than in those without OSA. Patients with severe OSA also had a higher RSI score and RFS than those with mild to moderate OSA. Apnea and hypopnea index degree and percentage of recording time for <90% oxygen saturation showed positive correlation with LPR symptoms. But the lowest blood oxygen saturation during the recording time was negatively correlated with LPR symptoms. The mean RSI score and RFS before UPPP surgery were 15.88 ± 4.85 and 13.18 ± 4.80, after surgery decreasing to 9.53 ± 4.16 and 8.65 ± 4.87, respectively (P <.05). In 25 patients where surgery was successful, RSI scores, RFSs and individual RSI variables decreased after surgery.

Conclusions: LPR symptoms are common among OSA patients, and the coexistence of OSA and LPR cannot be ignored. Successful UPPP surgery potentially reduces LPR symptoms and improves laryngoscopic signs by alleviating sleep respiratory disorders. Level of Evidence: 3.

Keywords: laryngopharyngeal reflux; obstructive sleep apnea; reflux finding score; reflux symptom index.

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Conflict of interest statement

The authors declared that there is no other funding, financial relationships, or conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Flow diagram of participates. AHI, apnea hypopnea index; CPAP, continuous positive airway pressure; PSG, polysomnography; RFS, reflux finding score; RSI, reflux symptom index; UPPP, uvulopalatopharyngoplasty surgery
FIGURE 2
FIGURE 2
Correlation of laryngopharyngeal reflux and sleep parameters. AHI, apnea hypopnea index; CT90, percentage of recording time when oxygen saturation <90%; L‐SpO2, lowest SpO2 during sleep; RFS, reflux finding score; RSI, reflux symptom index
FIGURE 3
FIGURE 3
Reflux symptom index scores before and after UPPP surgery in different groups. * 𝑃 <.05 compared with before uvulopalatopharyngoplasty group
See this image and copyright information in PMC

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