Swallowing dysfunction related to obstructive sleep apnea: a nasal fibroscopy pilot study

Patients with obstructive sleep apnea (OSA) may have subclinical swallowing abnormalities due to progressive mechanical trauma of the pharyngeal tissues caused by snoring. There are few trials on swallowing among OSA patients, and most of them used videoradiography. The aim of this trial was to show swallowing function in OSA patients by nasal fibroscopy.

Eleven patients with OSA diagnosed by polysomnography, with a mean age of 48 ± 14 years, without spontaneous complaints of swallowing, and 14 non-snoring volunteers, with a mean age of 47 ± 12 years, without spontaneous complaints of swallowing, participated in the study. The participants were evaluated using nasal fibroscopy. Each participant was offered diet boluses (5 and 10 ml) such as thin liquids, purée, and solids, and their swallowing function was determined according to the following criteria: (1) premature oral leakage to the pharynx; (2) laryngeal penetration; (3) tracheal aspiration; and (4) pharyngeal stasis.

Sixty-four percent of the OSA patients presented premature oral leakage, 55% presented pharyngeal stasis of the bolus after swallowing, and we did not observe laryngeal penetration or tracheal aspiration. There were no subclinical manifestations in the control group.

OSA patients presented subclinical manifestations of abnormal swallowing, when analyzed using nasal fibroscopy, possibly associated with neuromuscular injury caused by snoring.