Characteristics, Risk Factors, and Long‐Term Outcomes of Dysphagia Following Modified Uvulopalatopharyngoplasty: A Mixed‐Methods Study

Abstract

ABSTRACT Objective and Design Modified Uvulopalatopharyngoplasty (mUPPP) is a standard surgical intervention for Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS), but postoperative dysphagia remains an underdiagnosed and poorly managed complication due to the lack of standardised assessment protocols. This prospective mixed‐methods observational study aimed to investigate the clinical characteristics, independent risk factors, and long‐term outcomes of dysphagia following mUPPP. Main Outcome Measures A prospective observational study was conducted on 120 OSAHS patients undergoing mUPPP. A mixed‐methods assessment (EAT‐10, interviews, and FEES) was performed at 2 weeks, 1, 6, and 12 months postoperatively. Univariate and multivariate logistic regression analyses were used to identify independent risk factors. Results The rate of patients screening positive for clinically significant dysphagia symptoms (EAT‐10 ≥ 3, patient‐reported screening threshold) was 63.3% at 2 weeks postoperatively. FEES confirmed pathological swallowing abnormalities, such as delayed pharyngeal response and aspiration risk, in over 94% of EAT‐10‐positive patients. Four independent risk factors were identified: female gender, gastroesophageal reflux disease (GERD), anxiety/depression, and excessive daytime sleepiness (ESS ≥ 10). Symptoms persisted in approximately 19.2% of patients at 6 months and 9.2% at 12 months, with patients having multiple risk factors showing a significantly higher risk of long‐term persistence. Conclusion Dysphagia is a common and persistent sequela following mUPPP. The combination of EAT‐10 and FEES is recommended for comprehensive postoperative monitoring. Preoperative identification and management of risk factors (gender, GERD, psychological status, and sleepiness) are crucial for risk stratification and implementing personalised interventions to reduce the burden of persistent dysphagia.