Objectives: The aim of this study has been to analyze effects on Quality of Life (QoL) of the multilevel surgery for Obstructive Sleep Apnea (OSA). Also, we have compared the impact on QoL of two different treatments for patients with moderate to severe OSA such as CPAP and transoral robotic surgery (TORS). Design: 67 OSA patients who underwent multilevel robotic surgery and 67 OSA patients treated with CPAP were enrolled in a Group 1 and Group 2 respectively. The Glasgow Benefit Inventory (GBI) questionnaire has been administrated to all patients to evaluate the changes in the QoL after the different OSA treatment. Respiratory outcomes pre and post treatment were evaluated and compared. Results: Group 1 showed a GBI total average value of +30.4, whereas the group 2 a value of +33.2 . No statistical difference emerged (p=0.4). General benefit score showed no difference between groups (p = 0.1). Better values of social status benefit (p= 0.0006) emerged in CPAP Group, whereas greater physical status benefit (p=0.04) was showed in TORS Group. Delta-AHI (-23.7 ± 14.3 vs -31.7 ± 15.6; p = 0.001), Delta-ODI (-24.5 ± 9.5 vs. -29.4 ±10.5; p = 0.001) showed better values in CPAP group. Therapeutic success rate of Multilevel TORS Group was 73.1% and 91% in CPAP group (p = 0.01) respectively. Conclusion: Multilevel TORS and CPAP have a positive effect in quality of life of OSA patients. Greater social support has been reported in CPAP group and better physical health status in TORS group.

Objective: To study the profile of patients with obstructive sleep apnea syndrome (OSAS) and laryngopharyngeal reflux (LPR) at the hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring (HEMII-pH) and to compare their reflux findings with LPR patients without OSAS. Design: Prospective controlled study. Methods: Patients with LPR and OSAS were prospectively recruited from Augustus 2019 to June 2020. The profile of hypopharyngeal reflux events (HRE) of patients was studied through a breakdown of the HEMII-pH findings over the 24-hour of testing. Reflux symptom score (RSS), gastrointestinal and HEMII-pH outcomes were compared between LPR patients and patients with LPR and OSAS. Multivariate analysis was used to study the relationship between reflux data and the following sleep outcomes: Apnea-Hypopnea Index, Epworth Slippiness Scale (ESS) and paradoxical sleep data. Results: A total of 89 patients completed the study. There were 45 patients with LPR and 44 subjects with both OSAS and LPR. The numbers of upright and daytime HREs and the otolaryngological RSS were significantly higher in patients with LPR compared with those with OSAS and LPR. There was a significant positive association between RSS quality of life score and ESS (p=0.001). The occurrence of HREs in the evening was associated with higher ESS (p=0.015). Patients with OSAS, LPR and GERD had higher number of nocturnal HREs compared with those without GERD (p=0.001). Conclusion: The presence of OSAS in LPR patients is associated with less severe HEMII-pH and ear, nose and throat symptoms. There may have different OSAS patient profiles according to the occurrence of GERD.

Objective: To investigate prevalence and epidemiological and clinical factors associated with OD and GD in COVID-19 patients according to the disease severity. Study design: Cross-sectional study. Methods: A total of 2,579 patients with a positive diagnosis of COVID-19 were identified between March 22 and June 3, 2020 from 18 European hospitals. Epidemiological and clinical data were extracted. Otolaryngological symptoms, including OD and GD were collected through patient-reported outcome questionnaire and sniffin-sticks tests were carried out in a subset of patients. Results: A total of 2,579 patients were included, including 2,166 mild (84.0%), 144 moderate (5.6%) and 269 severe-to-critical (10.4%) patients. Mild patients presented an otolaryngological picture of the disease with OD, GD, nasal obstruction, rhinorrhea and sore throat as the most prevalent symptoms. The prevalence of subjective OD, GD were 73.7 and 46.8% and decrease with the severity of the disease. Females had higher prevalence of subjective OD and GD compared with males. Diabetes was associated with a higher risk to develop GD. Among the subset of patients who benefited from psychophysical olfactory evaluations, there were 75 anosmic, 43 hyposmic and 113 normosmic patients. The prevalence of anosmia significantly decreased with the severity of the disease. Anosmia or hyposmia were not associated with any nasal disorder, according to SNOT-22. Conclusion: OD and GD are more prevalent in patients with mild COVID-19 compared with individuals with moderate, severe or critical diseases. Females might have a higher risk of developing OD and GD compared with males.