Avaliação da disfagia e do refluxo laringofaringeo em pacientes com apnéia obstrutiva do Sono

• Ano de defesa: 2018
• Autor(a) principal: Caparroz, Fabio de Azevedo [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Obstructive sleep anea; Laryngopharyngeal reflux; Deglutition disorders; Apneia obstrutiva do sono; Refluxo laringofaríngeo; Transtornos de deglutição
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6370256; https://repositorio.unifesp.br/handle/11600/52811

Objectives: to evaluate whether the presence of signs and symptons suggestive of laryngopharingeal reflux are associated with the presence of dysphagia in patients with moderate and severe obstructive sleep apnea (OSA), and also evaluate whether endoscopic signs of dysphagia could be reverted by treatment with CPAP in patients with OSA. Methods: 70 patients among 18 and 70 years old with moderate or severe OSA were included in the study. The following questionnaries were applied: RSI (Reflux Sympton Index) and Quality of Life in Swallowing Disorders (Swal-Qol). Functional Endoscopy Evaluation of Swallowing Safety (FEESS) and video-laryngoscopy, in order to obtain Reflux Finding Score (RFS), were also performed. The patients with diagnosis of dysphagia on FEESS were followed-up to 3 months, and then reavaluated according to the same protocol. Results: the prevalence of laryngopharingeal reflux on our sample was 59,7%, and the prevalence of dysphagia was 27,3%, inferior than previous studies. Association between laryngopharingeal reflux and dysphagia was found on 17,1% of the patients, with no statistical significance. Lower quality of life scores were observed in only one domain of Swal-Qol in patients with dysphagia and OSA. There was a significantly improvement of deglutition disorders on FEESS after treatment with CPAP (p=0,004), as well as quality of life measured by Swal-Qol (global score, p = 0,028), in patients with dysphagia and OSA, after 3 months. Conclusions: There was no association between laryngopharingeal reflux and dysphagia in patients with OSA on the present study. Prevalence of dysphagia, showed mostly by premature oral leakage, was 27,3% on our sample, inferior to previous studies. It seems to be a lower additional impact on quality of life, measured by Swal-Qol, in patients with dysphagia and OSA. Treatment with CPAP was capable of reverting endoscopic signs of dysphagia on FEESS in patients with OSA.