Persistent dysphagia after laser uvulopalatoplasty - A videoradiographic study of pharyngeal function

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.