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.