Disclosures: In Sung Choi, MD, PhD: No financial relationships or conflicts of interest

Objective: Some obstructive sleep apnea (OSA) patients may present swallowing dysfunction, such as premature loss of food to hypopharynx, food stasis in the hypopharynx and laryngeal penetration without subjective symptoms. Expansion sphincter pharyngoplasty (ESP) is the surgery for OSA patients by dividing the muscle on the sides of the throat behind the tonsil (palatopharyngeus) and pulling it forward and laterally to sew it in place. We aimed to find out the changes of swallowing function using videofluoroscopic swallowing study (VFSS) in OSA patients before and after ESP.

Design: Pre-post interventional study Setting : Tertiary hospital Participants : Eight OSA patients (7 men and 1 woman, age: 55.4±5.6 years, Apnea-Hypopnea Index (AHI): 33.9±21.1%, Body Mass Index: 26.7±3.86 kg/m2) who underwent ESP

Interventions: ESP, VFSS before and 1 month after ESP

Main Outcome Measures: On VFSS, oral transit time (OTT), pharyngeal transit time (PTT), pharyngeal delay time (PDT), and laryngeal elevation (LE) were checked. AHI is estimated from the average number of episodes of apnea (cessation of airflow with duration of at least 10 seconds) plus episodes of hypopnea (reduced airflow) per hour during sleep.

Results: All the VFSS parameters were within normal ranges. PTT with liquid diet became shorter after ESP (p = 0.050). Other VFSS parameters did not show any differences before and after ESP. There was no correlation between AHI and VFSS parameters. Conclusions: ESP improved pharyngeal function with liquid diet. ESP might help pharyngeal passage for liquid diet in OSA patients by expanding the oropharynx. However, swallowing function was not correlated with the severity of the OSA.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-changes-of-swallowing-function-in-obstructive-sleep-apnea-patients-before-and-after-expansion-sphincter-pharyngoplasty/