Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea.
BACKGROUND
Upper airway nerve and muscle damage associated with obstructive sleep apnea may impair the strength and dynamics of pharyngeal and esophageal contractions during swallowing.


OBJECTIVE
To evaluate the presence of alterations in pharyngoesophageal manometry in patients with obstructive sleep apnea with and without oropharyngeal dysphagia.


METHODS
This study prospectively evaluated 22 patients with obstructive sleep apnea without spontaneous complaints of dysphagia, using a questionnaire, fiberoptic endoscopic evaluation of swallowing, and pharyngoesophageal manometry, including measurement of the upper and lower esophageal sphincter pressures and mean pharyngeal pressures at three levels during swallowing.


RESULTS
The dysphagia group consisted of 17 patients (77.3%) in whom swallowing abnormalities were detected on fiberoptic endoscopic evaluation of swallowing (n=15; 68.2%) and/or in the questionnaire (n=7; 31.8%). The five remaining cases comprised a control group without oropharyngeal dysphagia. In all cases of abnormalities on fiberoptic endoscopic evaluation of swallowing, there was premature bolus leakage into the pharynx. There was no statistically significant difference between the groups regarding any of the pharyngoesophageal manometry measurements, age, or severity of obstructive sleep apnea.


CONCLUSIONS
Pharyngoesophageal manometry detected no statistically significant difference between the groups with and without oropharyngeal dysphagia.
Department of Otorhinolaryngology, Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil; Health Sciences, Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil. Electronic address: lu21moreira@hotmail.com.
Luciana Almeida Moreira da Paz
LA
Oliveira
Department of Gastroenterology, Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil.
Luiz Henrique de Souza
LH
Fontes
Department of Otorhinolaryngology, Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil; Department of Otorhinolaryngology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
Michel Burihan
MB
Cahali
D000328:Adult; D003679:Deglutition; D003680:Deglutition Disorders / Q000209:etiology* / Q000503:physiopathology; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010614:Pharynx / Q000503:physiopathology; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000150:complications*; D011795:Surveys and Questionnaires
Apneia do sono tipo obstrutiva; Deglutition disorders; Esophagus; Esôfago; Faringe; Manometria; Manometry; Obstructive sleep apnea; Pharynx; Transtornos de deglutição