Persistent dysphagia after laser uvulopalatoplasty: a videoradiographic study of pharyngeal function.
In a follow-up study of 79 patients two years after laser uvulopalatoplasty 21 (27%) reported persistent postoperative dysphagia, with aspiration symptoms in 22%. None of the patients had suffered from recurrent pneumonia. A total of 4% of the patients regretted the treatment because of their dysphagia problems. The objective of this study was to examine oral and pharyngeal function videoradiographically during swallowing in the patients with persistent dysphagia, to determine whether the subjective symptoms of dysphagia correlated with objective signs of pharyngeal dysfunction. Pharyngeal function during swallowing was deviant in 76% of the dysphagic patients. In 52% of the dysphagic patients premature leakage of bolus down to different levels of the pharynx, from the tongue base to sinus piriformis, was observed before the swallowing reflex was elicited. In the dysphagic patients substantial bolus retention was observed on the epiglottis or in the valleculae alter the propagation wave had passed (43%) as well as epiglottal dysmotility (24%). Of the dysphagic patients, 10% could not avoid aspiration during the examination. These findings could explain the symptoms reported by the patients.
Isberg
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Department of Oral and Maxillofacial Radiology, Umeå University, Sweden. Annika.Isberg@omfrad.umu.se
Levring-Jäghagen
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Dahlström
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M
Dahlqvist
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D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000503:physiopathology; D002933:Cineradiography; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000209:etiology* / Q000503:physiopathology; D004825:Epiglottis / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000209:etiology; D006801:Humans; D007830:Larynx / Q000503:physiopathology; D053685:Laser Therapy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010160:Palate, Soft / Q000601:surgery*; D017060:Patient Satisfaction; D010614:Pharynx / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012891:Sleep Apnea Syndromes / Q000601:surgery; D012913:Snoring / Q000601:surgery; D014059:Tongue / Q000503:physiopathology; D014609:Uvula / Q000601:surgery*; D014743:Videotape Recording