A. Isberg et al., Persistent dysphagia after laser uvulopalatoplasty - A videoradiographic study of pharyngeal function, ACT OTO-LAR, 118(6), 1998, pp. 870-874
In a Follow-up study of 79 patients two years after laser uvulopalatoplasty
21 (27%) reported persistent postoperative dysphagia, with aspiration symp
toms in 22%. None of the patients had suffered from recurrent pneumonia. A
total of 4% of the patients regretted the treatment because of their dyspha
gia problems. The objective of this study was to examine oral and pharyngea
l function videoradiographically during swallowing in the patients with per
sistent dysphagia, to determine whether the subjective symptoms of dysphagi
a correlated with objective signs of pharyngeal dysfunction. Pharyngeal fun
ction during swallowing was deviant in 76% of the dysphagic patients. In 52
% of the dysphagic patients premature leakage of bolus down to different le
vels of the pharynx, from the tongue base to sinus piriformis, was observed
before the swallowing reflex was elicited. In the dysphagic patients subst
antial bolus retention was observed on the epiglottis or in the valleculae
after the propagation wave had passed (43%) as well as epiglottal dysmotili
ty (24%). Of the dysphagic patients, 10% could not avoid aspiration during
the examination. These findings could explain the symptoms reported by the
patients.