Changes in Symptom Scales of Laryngopharyngeal Reflux Following Obstructive Sleep Apnea Surgery: A Systematic Review...

Obstructive sleep apnea (OSA) is a serious health concern having been associated with laryngopharyngeal reflux (LPR), but the impact of OSA treatment, particularly sleep surgery, on LPR has not yet been fully investigated. This study aims to comprehensively analyze the current available literature to study the impact of soft tissue sleep surgery on LPR manifestations and symptoms in patients with OSA. Six databases, including PubMed, Embase, ScienceDirect, Cochrane Library, Web of Science, and Scopus, were systematically searched. Studies focusing on changes of LPR symptom scales, including Reflux Symptom Index (RSI) and Reflux Finding Score (RFS), before and after upper airway sleep surgery were included. Qualitative and quantitative analyses of the literature and different modalities were performed. Six studies with 278 patients were enrolled eventually. After surgery, most of the LPR symptom parameters improved. The meta-analysis further showed that in changes of RSI, "difficulty breathing" showed the largest effect of improvement (Hedge's g: -1.21 (95% confidence interval (CI): -1.84 to -0.58)). In changes of RFS, "diffuse laryngeal edema" achieved the largest improvement (Hedge's g: -1.30 (95% CI: -2.51 to -0.09)) postoperatively. The findings potentially indicated that LPR symptoms could relieve following OSA surgery, especially in certain symptom domains, and better postoperative respiratory status may have the potential to alleviate acute inflammation and the severity of LPR.