Introduction
Obstructive sleep apnea (OSA) is a growing public health problem. About
2%–4% of middle-aged adults have OSA.1 Middle-aged
people suffer from sleep-disordered breathing with a high percentage of
83.2 Repetitive collapse and reopening of the upper
airway during sleep are two major characteristics of OSA, resulting in
intermittent hypoxia (IH) and sleep fragmentation. IH correlates with
systemic/airway inflammation and oxidative stress.3The treatments of OSA include continuous positive airway pressure (CPAP)
or surgery.
Uvulopalatopharyngoplasty (UPPP)
was first suggested by Fujita et al.4 If the
obstruction site of OSA is located at the palatopharyngeal level, UPPP
usually achieve an ideal outcome by eliminating redundant mucosal folds,
hypertrophic tonsils and the excessively thickened and elongated soft
palate.
Laryngeal mucosal inflammation and damage of laryngopharyngeal reflux
(LPR) occurs when gastric acid flow back to the laryngopharynx, and is a
common disease in otolaryngology5.
Although
24-hour pH monitoring is the gold standard for diagnosing the presence
of LPR, Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) are
more commonly used and useful in diagnosing LPR and quantifying the
severity of LPR symptoms.5, 6
Chronic upper airway inflammation is the result of many conditions,
among which OSA and LPR are two reasons that cannot be ignored. The
presence of LPR in OSA is very frequent: 20%–67% OSA patients coexist
with LPR.7 In recent years, many studies have explored
the association between OSA and LPR, but the correlation between them is
still controversial. Some studies demonstrated that CPAP treatment
significantly improved reflux symptoms in OSA
patients.8 But few studies have been done about the
effect of surgery treatment for OSA on reflux disease. The aim of this
study was to evaluate the change
in laryngeal reflux symptoms and signs after UPPP for OSA, based on
patients’ responses to the RSI and RFS questionnaire.