Fiberoptic Endoscopic Evaluation of Swallowing and the Brazilian Version of the Eating Assessment Tool-10 in Resistant Hypertensive Patients with Obstructive Sleep Apnea

Overview

Journal Braz J Otorhinolaryngol

Specialty Otorhinolaryngology

Date 2022 Mar 4

PMID 35241385

Authors

Mariana Pinheiro Brendim

Carla Rocha Muniz

Thalyta Georgia Vieira Borges

Flavia Rodrigues Ferreira

Elizabeth Silaid Muxfeldt

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to describe the prevalence and characteristics of OD through Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and the Eating Assessment Tool-10 (EAT-10) in hypertensive patients with OSA, as well as to describe the sensitivity of EAT-10 for the detection of OD in this population.

Methods: This study included a convenience sample in which 85 resistant hypertensive patients diagnosed with OSA in an university hospital participated. Participants were subjected to the EAT-10 (index test) and FEES (reference standard).

Results: The median EAT-10 score was 2 (0-5.5). According to the FEES, 27 participants did not have dysphagia, 42 had mild dysphagia and 16 had mild to moderate dysphagia. The sensitivity of the EAT-10 was 70.7% (95% CI: 57.3-81.9) at a cutoff score ≥1, with a discriminatory power of 67.4% (p = 0.005). The most prevalent symptom in this population was "food stuck in the throat", while the most prevalent signs were delayed initiation of the pharyngeal phase of swallowing, premature bolus spillage and pharyngeal residue.

Conclusion: In our study, the cutoff score for the EAT-10 for screening for OD in this population was ≥ 1. In conclusion, this population presented a high prevalence of dysphagia detected in FEES and its severity is associated with higher EAT-10 scores.

Citing Articles

Association between swallowing dynamics, tongue pressure and pulmonary function in patients with idiopathic pulmonary fibrosis.

Vasconcellos P, Mafort T, Ribeiro-Alves M, Costa C BMC Pulm Med. 2024; 24(1):315.

PMID: 38965496 PMC: 11223328. DOI: 10.1186/s12890-024-03117-3.

Swallowing outcome to speech therapy intervention in resistant hypertensive patients with obstructive sleep apnea.

Borges T, Muniz C, Ferreira F, Brendim M, Muxfeldt E Eur Arch Otorhinolaryngol. 2022; 280(1):443-453.

PMID: 36098863 PMC: 9469056. DOI: 10.1007/s00405-022-07612-3.

References

Giraldo-Cadavid L, Leal-Leano L, Leon-Basantes G, Bastidas A, Garcia R, Ovalle S . Accuracy of endoscopic and videofluoroscopic evaluations of swallowing for oropharyngeal dysphagia. Laryngoscope. 2016; 127(9):2002-2010. DOI: 10.1002/lary.26419. View

Bassiouny A, Nasr S, Mashaly M, Ayad E, Qotb M, Atef A . Electron microscopy study of peripheral nerves in the uvulae of snorers and obstructive sleep apnoea patients. J Laryngol Otol. 2008; 123(2):203-7. DOI: 10.1017/S0022215108002971. View

Jaghagen E, Berggren D, Isberg A . Swallowing dysfunction related to snoring: a videoradiographic study. Acta Otolaryngol. 2000; 120(3):438-43. DOI: 10.1080/000164800750000702. View

Friberg D, Gazelius B, Lindblad L, Nordlander B . Habitual snorers and sleep apnoics have abnormal vascular reactions of the soft palatal mucosa on afferent nerve stimulation. Laryngoscope. 1998; 108(3):431-6. DOI: 10.1097/00005537-199803000-00022. View

Carey R, Calhoun D, Bakris G, Brook R, Daugherty S, Dennison-Himmelfarb C . Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association. Hypertension. 2018; 72(5):e53-e90. PMC: 6530990. DOI: 10.1161/HYP.0000000000000084. View

Shah F, Forsgren S, Holmlund T, Levring Jaghagen E, Berggren D, Franklin K . Neurotrophic factor BDNF is upregulated in soft palate muscles of snorers and sleep apnea patients. Laryngoscope Investig Otolaryngol. 2019; 4(1):174-180. PMC: 6383323. DOI: 10.1002/lio2.225. View

Caparroz F, Campanholo M, Sguillar D, Haddad L, Park S, Bittencourt L . A Pilot Study on the Efficacy of Continuous Positive Airway Pressure on the Manifestations of Dysphagia in Patients with Obstructive Sleep Apnea. Dysphagia. 2018; 34(3):333-340. DOI: 10.1007/s00455-018-9944-1. View

Levring Jaghagen E, Franklin K, Isberg A . Snoring, sleep apnoea and swallowing dysfunction: a videoradiographic study. Dentomaxillofac Radiol. 2004; 32(5):311-6. DOI: 10.1259/dmfr/29209140. View

Bhutada A, Broughton W, Garand K . Obstructive sleep apnea syndrome (OSAS) and swallowing function-a systematic review. Sleep Breath. 2020; 24(3):791-799. DOI: 10.1007/s11325-020-02037-w. View

10.

Epstein L, Kristo D, Strollo Jr P, Friedman N, Malhotra A, Patil S . Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009; 5(3):263-76. PMC: 2699173. View

11.

Patel J, Ray B, Fernandez-Salvador C, Gouveia C, Zaghi S, Camacho M . Neuromuscular function of the soft palate and uvula in snoring and obstructive sleep apnea: A systematic review. Am J Otolaryngol. 2018; 39(3):327-337. DOI: 10.1016/j.amjoto.2018.03.006. View

12.

Corradi A, Valarelli L, Grechi T, Eckeli A, Aragon D, Kupper D . Swallowing evaluation after surgery for obstructive sleep apnea syndrome: uvulopalatopharyngoplasty vs. expansion pharyngoplasty. Eur Arch Otorhinolaryngol. 2018; 275(4):1023-1030. DOI: 10.1007/s00405-018-4898-3. View

13.

ONeil K, Purdy M, Falk J, Gallo L . The Dysphagia Outcome and Severity Scale. Dysphagia. 1999; 14(3):139-45. DOI: 10.1007/PL00009595. View

14.

Valbuza J, De Oliveira M, Zancanella E, Conti C, Prado L, Carvalho L . Swallowing dysfunction related to obstructive sleep apnea: a nasal fibroscopy pilot study. Sleep Breath. 2011; 15(2):209-13. DOI: 10.1007/s11325-010-0474-9. View

15.

Friberg D, Gazelius B, Hokfelt T, Nordlander B . Abnormal afferent nerve endings in the soft palatal mucosa of sleep apnoics and habitual snorers. Regul Pept. 1997; 71(1):29-36. DOI: 10.1016/s0167-0115(97)01016-1. View

16.

Langmore S . History of Fiberoptic Endoscopic Evaluation of Swallowing for Evaluation and Management of Pharyngeal Dysphagia: Changes over the Years. Dysphagia. 2017; 32(1):27-38. DOI: 10.1007/s00455-016-9775-x. View

17.

Bowen A, Nowacki A, Kominsky A, Trask D, Benninger M, Bryson P . Voice and swallowing outcomes following hypoglossal nerve stimulation for obstructive sleep apnea. Am J Otolaryngol. 2017; 39(2):122-126. DOI: 10.1016/j.amjoto.2017.12.011. View

18.

Baijens L, Pilz W, Kremer B, Passos V . Identifying Patterns of FEES-Derived Swallowing Trajectories Using Group-Based Trajectory Model. Dysphagia. 2015; 30(5):529-39. PMC: 4579259. DOI: 10.1007/s00455-015-9632-3. View

19.

Teramoto S, Ishii T, Matsuse T . Relationship between swallowing function and gas exchange during day and night in patients with obstructive sleep apnea syndrome. Dysphagia. 2001; 16(4):249-53. DOI: 10.1007/s00455-001-0083-7. View

20.

Real C, Balbinot J, Signorini A, Hubner L, Machado G, Dornelles S . Characterization of posterior leakage in swallowing. Codas. 2020; 32(4):e20190072. DOI: 10.1590/2317-1782/20202019072. View