Ağır ve orta düzey obstrüktif uyku apne sendromu olan hastalarda sürekli pozitif hava yolu basıncı tedavisinin yutma fonksiyonu üzerine etkileri
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Dosyalar
Tarih
2017
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Obstrüktif Uyku Apne Sendromu (OSAS) hastalarında subklinik yutma fonskiyonun da bozukluk gözlenmektedir. Çalışmamızın amacı OSAS tedavisinde sık olarak kullanılan CPAP tedavisinin bozulmuş yutma fonksiyonu üzerine etkilerini araştırmaktır.
Gereç ve Yöntem: Ege Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Anabilim dalında ağır ve orta düzey Obstrüktif Uyku Apne Sendromu tanısı konulup CPAP tedavisi başlanan 44 hasta çalışmaya alındı. Yapılan FEES değerlendirmesinde yutma fonksiyonlarında (erken dökülme, rezidü, penetrasyon, aspirasyon… vb) bozukluk saptanan 25 hasta çalışmaya dahil edildi. Hastaların sosyodemografik özellikleri, OSAS ile ilgili (apne, hipopne, AHİ indeksi…vs) ve yutma fonskiyon bozukluğu ile ilgili klinik bulguları kaydedildi. Hastalar 3 aylık CPAP tedavisi sonunda tekrar değerlendirildi.
Bulgular: Çalışmayı katılan 25 hastanın 7‘sinin CPAP tedavisini bırakması veya kullanmaması ve 2 hastanın kontrole gelmemesi nedeniyle 16 kişi tamamladı. Hastaların OSAS şiddetleri ile yutma bozukluğu arasında istatiksel olarak anlamlı ilişki saptanmadı (p >0,05). Hastaların valleculadaki rezidü varlığı açısından yarı-katı kıvamda olan yoğurt ile yapılan yutma testinde tedavi öncesi ile tedavi sonrası istatiksel olarak anlamlı düzelme izlendi (p<0,05). Yine yarı-katı kıvamda olan yoğurt ile yapılan yutma testinde tedavi öncesi ile tedavi sonrası valleculadaki rezidü şiddetleri arasında istatiksel olarak anlamlı düzelme saptandı (p<0,05). Yutma bozukluğu olan ile olmayan gruplar arasında sigara içiciliği yönünden istatiksel olarak anlamlı fark saptandı (p<0,05).
Sonuç: Literatürde OSAS hastalarında yutma fonksiyon bozukluğunu inceleyen çalışmalar olmasına rağmen CPAP tedavisinin bozulmuş yutma fonskiyonu üzerine etkisini araştıran bir çalışma bulunmamaktadır. Çalışmamızda literatür ile benzer olarak OSAS hastalarında subklinik yutma fonksiyon bozukluğu saptanmış olup, CPAP tedavisi ile rezidü birikimi ve rezidü kalıntı şiddetinde anlamlı düzelme izlenmiştir.
Objective: In patients with obstructive sleep apnea syndrome (OSAS), subclinical swallowing dysfunction is observed. The purpose of our study is to investigate the effects of CPAP treatment, which is frequently used in OSAS treatment, on swallowing dysfunction. Methods: At the Faculty of Medicine Department of Chest Diseases of Ege University, 44 patients with severe and moderate OSAS diagnosed were included in the study. Twenty-five patients whose swallowing dysfunction (premature spillage, residue, penetration, aspiration.. etc) was detected in the FEES evaluation were included in the Clinical findings related to sociodemographic characteristics of patients, OSAS (apnea, hypopnea, AHI index ... etc) and swallowing dysfunction were recorded. Patients were reevaluated at the end of 3-month CPAP treatment. Results: Sixteen patients completed the study because 7 of the 25 patients who participated in the study did not give up or use CPAP therapy and 2 patients did not come to the control. There was no statistically significant relationship between severity of OSAS and swallowing dysfunction (p> 0,05). Statistically significant improvements were observed in pre-treatment and post-treatment swallow tests with semi-solid yoghurt in terms of presence of vallecula residues in patients (p <0.05). Statistically significant improvements were observed in pre-treatment and post-treatment swallow tests with semi-solid yoghurt in terms of severity of vallecula residues in patients (p <0.05). There was a statistically significant between smoking and the groups with or without swallowing dysfunction (p <0.05). Conclusions: Although there are studies in the literature that examine swallowing dysfunction in OSAS patients but there is no study investigating the effect of CPAP treatment on impaired swallowing function. In our study, similar to the literature, subclinical swallowing dysfunction was detected in OSAS patients and significant improvement was observed the residual accumulation and residual severity after CPAP treatment.
Objective: In patients with obstructive sleep apnea syndrome (OSAS), subclinical swallowing dysfunction is observed. The purpose of our study is to investigate the effects of CPAP treatment, which is frequently used in OSAS treatment, on swallowing dysfunction. Methods: At the Faculty of Medicine Department of Chest Diseases of Ege University, 44 patients with severe and moderate OSAS diagnosed were included in the study. Twenty-five patients whose swallowing dysfunction (premature spillage, residue, penetration, aspiration.. etc) was detected in the FEES evaluation were included in the Clinical findings related to sociodemographic characteristics of patients, OSAS (apnea, hypopnea, AHI index ... etc) and swallowing dysfunction were recorded. Patients were reevaluated at the end of 3-month CPAP treatment. Results: Sixteen patients completed the study because 7 of the 25 patients who participated in the study did not give up or use CPAP therapy and 2 patients did not come to the control. There was no statistically significant relationship between severity of OSAS and swallowing dysfunction (p> 0,05). Statistically significant improvements were observed in pre-treatment and post-treatment swallow tests with semi-solid yoghurt in terms of presence of vallecula residues in patients (p <0.05). Statistically significant improvements were observed in pre-treatment and post-treatment swallow tests with semi-solid yoghurt in terms of severity of vallecula residues in patients (p <0.05). There was a statistically significant between smoking and the groups with or without swallowing dysfunction (p <0.05). Conclusions: Although there are studies in the literature that examine swallowing dysfunction in OSAS patients but there is no study investigating the effect of CPAP treatment on impaired swallowing function. In our study, similar to the literature, subclinical swallowing dysfunction was detected in OSAS patients and significant improvement was observed the residual accumulation and residual severity after CPAP treatment.
