umu.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Levring Jäghagen, Eva, DDS, PhDORCID iD iconorcid.org/0000-0001-8807-3500
Alternative names
Publications (10 of 37) Show all publications
Shah, F., Franklin, K. A., Holmlund, T., Levring Jäghagen, E., Berggren, D., Forsgren, S. & Stål, P. (2019). Desmin and dystrophin abnormalities in upper airway muscles of snorers and patients with sleep apnea. Respiratory Research, 20, Article ID 31.
Open this publication in new window or tab >>Desmin and dystrophin abnormalities in upper airway muscles of snorers and patients with sleep apnea
Show others...
2019 (English)In: Respiratory Research, ISSN 1465-993X, Vol. 20, article id 31Article in journal (Refereed) Published
Abstract [en]

The pathophysiology of obstruction and swallowing dysfunction in snores and sleep apnea patients remains unclear. Neuropathy and to some extent myopathy have been suggested as contributing causes. Recently we reported an absence and an abnormal isoform of two cytoskeletal proteins, desmin, and dystrophin, in upper airway muscles of healthy humans. These cytoskeletal proteins are considered vital for muscle function. We aimed to investigate for muscle cytoskeletal abnormalities in upper airways and its association with swallowing dysfunction and severity of sleep apnea. Cytoskeletal proteins desmin and dystrophin were morphologically evaluated in the uvula muscle of 22 patients undergoing soft palate surgery due to snoring and sleep apnea and in 10 healthy controls. The muscles were analysed with immunohistochemical methods, and swallowing function was assessed using videoradiography. Desmin displayed a disorganized pattern in 21 +/- 13% of the muscle fibres in patients, while these fibers were not present in controls. Muscle fibres lacking desmin were present in both patients and controls, but the proportion was higher in patients (25 +/- 12% vs. 14 +/- 7%, p = 0.009). The overall desmin abnormalities were significantly more frequent in patients than in controls (46 +/- 18% vs. 14 +/- 7%, p < 0.001). In patients, the C-terminus of the dystrophin molecule was absent in 19 +/- 18% of the desmin-abnormal muscle fibres. Patients with swallowing dysfunction had 55 +/- 10% desmin-abnormal muscle fibres vs. 22 +/- 6% in patients without swallowing dysfunction, p = 0.002. Cytoskeletal abnormalities in soft palate muscles most likely contribute to pharyngeal dysfunction in snorers and sleep apnea patients. Plausible causes for the presence of these abnormalities is traumatic snoring vibrations, tissue stretch or muscle overload.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Muscle, Upper airway dysfunction, Dysphagia, Pathophysiology, Cytoskeletal abnormalities, desmin, dystrophin
National Category
Cell and Molecular Biology Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-157211 (URN)10.1186/s12931-019-0999-9 (DOI)000459188400003 ()30764835 (PubMedID)
Available from: 2019-04-08 Created: 2019-04-08 Last updated: 2019-04-08Bibliographically approved
Gustafsson, N., Ahlqvist, J. & Levring Jäghagen, E. (2019). Long-term skill improvement among general dental practitioners after a short training programme in diagnosing calcified carotid artery atheromas on panoramic radiographs. European journal of dental education, 23, 54-61
Open this publication in new window or tab >>Long-term skill improvement among general dental practitioners after a short training programme in diagnosing calcified carotid artery atheromas on panoramic radiographs
2019 (English)In: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579, Vol. 23, p. 54-61Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To study general dental practitioners (GDPs) ability to detect calcified carotid artery atheromas (CCAAs) in panoramic radiographs (PRs) and if their diagnostic accuracy in long term is improved after a short training programme.

METHODS: Fourteen GDPs had their diagnostic accuracy regarding CCAA in PR assessed at baseline, 2 weeks and 1 year after training. Comparison was made with a reference standard based on consensus results from two experienced oral and maxillofacial radiologists. At each session, 100 radiographs were assessed individually by the GDPs. After the baseline assessment, the GDPs participated in a 2-hour training programme comprising a lecture and diagnostic training by calibration. The GDPs results before and after training were compared, as well as between follow-up sessions.

RESULTS: A significant improvement in diagnostic accuracy was observed with increased sensitivity (from 41.8% to 55.7%, P = 0.02) without a significant decrease in specificity (from 87.2% to 86.7%, P = 0.87). The Kappa values also increased (from 0.66 to 0.71, P = 0.04). At 1-year follow-up, the improvement compared to baseline remained significant. There were no significant changes between the 2-week and 1-year follow-up assessment.

CONCLUSION: A short training programme can significantly and sustainable improve GDPs diagnostic accuracy regarding CCAA.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
calcified carotid artery atheroma, carotid artery calcification, education, panoramic radiography, radiology
National Category
Dentistry
Research subject
Radiology; Odontology; education
Identifiers
urn:nbn:se:umu:diva-153768 (URN)10.1111/eje.12402 (DOI)000455041100015 ()30358024 (PubMedID)2-s2.0-85056352070 (Scopus ID)
Available from: 2018-12-01 Created: 2018-12-01 Last updated: 2019-05-20Bibliographically approved
Hägglund, P., Susanne, K., Olai, L., Ståhlnacke, K., Wester, P. & Levring Jäghagen, E. (2019). Older people with swallowing dysfunction and poor oral health are at greater risk of early death. Community Dentistry and Oral Epidemiology
Open this publication in new window or tab >>Older people with swallowing dysfunction and poor oral health are at greater risk of early death
Show others...
2019 (English)In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: We investigated the associations between swallowing dysfunction, poor oral health and mortality among older people in intermediate care in Sweden.

Methods: This prospective cohort study investigated 391 older people in 36 intermediate care units (clusters). Swallowing function was assessed with the timed water swallow test (TWST), and oral health with the revised oral assessment guide (ROAG) at baseline. Data were collected on age, sex, education level, multimorbidity, cognitive impairment, care dependency and body mass index (BMI). Time to mortality was recorded during the following year. The mixed effects Cox regression model with cluster as a random factor was used to estimate hazards ratios (HR) with 95% confidence intervals (CI).

Results: The median age of the participants was 84 years (interquartile range [IQR]: 11), and 53.3% were females. Mortality within one year was 25.1%. In the adjusted model, swallowing dysfunction and poor oral health were both independently associated with mortality (adjusted HR [aHR]: 1.67, 95% CI 1.02‐2.75; P = .041 and aHR: 1.98, 95% CI 1.07‐3.65; P = .029, respectively). Participants with combined swallowing dysfunction and poor oral health showed the highest mortality (35.0%) and 2.6 (95% CI 1.15‐5.89; P = .022) times higher mortality risk than those with normal swallowing function and good oral health (13.0%).

Conclusions: Swallowing dysfunction and poor oral health were identified as independent risk factors for mortality in older people in intermediate care. Although further studies are required to verify these findings, they suggest that systematic assessment of swallowing function and oral health status should be performed for care considerations.

Keywords
mortality, swallowing disorders, oral hygiene, oral care, elderly care
National Category
Geriatrics Dentistry
Identifiers
urn:nbn:se:umu:diva-157340 (URN)10.1111/cdoe.12491 (DOI)000482105300001 ()
Note

Originally included in thesis in manuscript form

Available from: 2019-03-14 Created: 2019-03-14 Last updated: 2019-09-16
Hägglund, P., Fält, A., Hägg, M., Wester, P. & Levring Jäghagen, E. (2019). Swallowing dysfunction as risk factor for undernutrition in older people admitted to Swedish short-term care: a cross-sectional study. Aging Clinical and Experimental Research, 31(1), 85-94
Open this publication in new window or tab >>Swallowing dysfunction as risk factor for undernutrition in older people admitted to Swedish short-term care: a cross-sectional study
Show others...
2019 (English)In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 31, no 1, p. 85-94Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Swallowing dysfunction and risk of undernutrition increase the risk of pneumonia, morbidity, and mortality. Short-term care is an unexplored care context, where many older people stay yearly.

AIM: This cross-sectional study aimed to describe and analyze the relationship between swallowing dysfunction and risk of undernutrition among older people in short-term care, including potential gender-related differences.

METHODS: In total, 391 people (209 women), aged ≥ 65 years (median age 84 years) and admitted to short-term care in five Swedish counties participated. They went through a timed water swallow test to assess swallowing dysfunction, including abnormal swallowing capacity and signs of aspiration (i.e., cough and voice change). Risk for undernutrition was assessed using the Minimal Eating Observation and Nutrition Form-version II.

RESULTS: Swallowing dysfunction was observed in 248 of 385 (63%) participants, including abnormal swallowing capacity in 213 of 385 (55%) and aspiration signs in 127 of 377 (34%). Abnormal swallowing capacity was more frequent among women (p = 0.030), whereas men with normal swallowing capacity exhibited signs of aspiration more frequently (cough p = 0.038, voice change p = 0.004). Risk of undernutrition was found in 91 of 390 (23%) participants, more frequently among women (p = 0.007). A logistic regression model revealed an increased risk of undernutrition among older people with abnormal swallowing capacity (OR 1.74, 95% CI 1.04-2.92, p = 0.034).

CONCLUSIONS: The high prevalence of swallowing dysfunction and risk of undernutrition highlight the need for a systematic screening program and feasible treatment to improve swallowing function for adequate and safe food intake among older people in short-term care.

CLINICAL TRIAL REGISTRATION: This study was registered with ClinicalTrials.gov on July 4, 2016, under NCT02825927.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Aspiration, Dysphagia, Elderly care, Gender, Malnutrition, Swallowing disorders
National Category
Geriatrics Dentistry Nutrition and Dietetics
Research subject
Geriatrics; Odontology; Caring Sciences
Identifiers
urn:nbn:se:umu:diva-146928 (URN)10.1007/s40520-018-0944-7 (DOI)000457534400011 ()29663160 (PubMedID)2-s2.0-85045421560 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-2127The Kamprad Family Foundation, 20132115
Available from: 2018-12-01 Created: 2018-12-01 Last updated: 2019-03-14Bibliographically approved
Shah, F., Holmlund, T., Levring Jäghagen, E., Berggren, D., Franklin, K. A., Forsgren, S. & Stål, P. (2018). Axon and Schwann Cell Degeneration in Nerves of Upper Airway Relates to Pharyngeal Dysfunction in Snorers and Patients With Sleep Apnea. Chest, 154(5), 1091-1098
Open this publication in new window or tab >>Axon and Schwann Cell Degeneration in Nerves of Upper Airway Relates to Pharyngeal Dysfunction in Snorers and Patients With Sleep Apnea
Show others...
2018 (English)In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 154, no 5, p. 1091-1098Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The pathophysiologic mechanism of nocturnal obstruction and swallowing dysfunction commonly occurring in patients with sleep apnea is unclear. The goal of this study was to investigate whether nerve injuries in the upper airways of snorers and patients with sleep apnea are associated with pharyngeal dysfunction and severity of sleep apnea.

METHODS: Twenty-two patients undergoing palatal surgery due to snoring and sleep apnea were investigated for a swallowing dysfunction by using videoradiography. Twelve healthy nonsnoring subjects were included as control subjects. Tissue samples from the soft palate at the base of the uvula were obtained in all patients and control subjects. Nerves and muscle were analyzed with immunohistochemical and morphologic methods, and the findings were correlated with swallowing function and degree of sleep apnea.

RESULTS: In the soft palate of patients, nerve fascicles exhibited a significantly lower density of axons (5.4 vs 17.9 x 10(-3) axons/mu m(2); P = .02), a smaller percentage area occupied by Schwann cells (17.5% vs 45.2%; P = .001) and a larger number of circular shaped Schwann cells lacking central axons (43.0% vs 12.7%; P < 0.001) compared with control subjects. The low density of axons was significantly related to degree of swallowing dysfunction (r = 0.5; P = .03) and apnea-hypopnea index > 5 (P = .03). Regenerating axons were frequently observed in patients compared with control subjects (11.3 +/- 4.2% vs 4.8 +/- 2.4%; P = .02).

CONCLUSIONS: Axon degeneration in preterminal nerves of the soft palate is associated with pharyngeal dysfunction in snorers and patients with sleep apnea. The most likely cause for the nerve injuries is traumatic snoring vibrations and tissue stretch, leading to swallowing dysfunction and increased risk for upper airway obstruction during sleep.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
muscle degeneration, nerve injury, OSA, swallowing dysfunction, upper airways
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-153546 (URN)10.1016/j.chest.2018.06.017 (DOI)000449273000023 ()29966666 (PubMedID)
Funder
Swedish Heart Lung Foundation, 20110210Swedish Heart Lung Foundation, 20140339
Available from: 2018-11-22 Created: 2018-11-22 Last updated: 2018-11-22Bibliographically approved
Gustafsson, N., Ahlqvist, J. B., Näslund, U., Wester, P., Buhlin, K., Gustafsson, A. & Levring Jäghagen, E. (2018). Calcified carotid artery atheromas in panoramic radiographs are associated with a first myocardial infarction: a case-control study. Oral surgery, oral medicine, oral pathology and oral radiology, 125(2), 199-205
Open this publication in new window or tab >>Calcified carotid artery atheromas in panoramic radiographs are associated with a first myocardial infarction: a case-control study
Show others...
2018 (English)In: Oral surgery, oral medicine, oral pathology and oral radiology, ISSN 2212-4403, E-ISSN 2212-4411, Vol. 125, no 2, p. 199-205Article in journal (Refereed) Published
Abstract [en]

Objective. The aim of this case-control study was to investigate whether patients with a first myocardial infarction (MI) had a higher prevalence of calcified carotid artery atheromas (CCAAs) on panoramic radiographs (PRs) than age-, gender-, and residential area-matched controls without MI. Study Design. Six hundred ninety-six cases with a first MI and 696 controls were included in this substudy of the Swedish multicentre PAROKRANK study. All participants underwent panoramic radiography, and the PRs were evaluated for CCAAs. Results. The prevalence of CCAAs detected by PR was 33.8% (235 of 696) in cases and 27.6% (192 of 696) in controls (odds ratio [OR] 1.24; 95% confidence interval [CI] 1.04-1.44; P = .012). Among males, 32.7% of cases (184 of 562) and 26.5% of controls (149 of 562) displayed CCAAs on PRs (OR 1.24; 95% CI 1.03-1.48; P = .022). Among both genders, bilateral CCAAs were significantly more common among cases than among controls (P = .002). Conclusions. Cases with recent MIs had a significantly higher prevalence of CCAAs on PRs compared with controls without MIs. This difference between groups was more pronounced for bilateral CCAAs. These findings supported the hypothesis that CCAA detection could serve as a risk indicator for future MIs.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC, 2018
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-144341 (URN)10.1016/j.oooo.2017.10.009 (DOI)000422751700018 ()29242130 (PubMedID)
Available from: 2018-02-08 Created: 2018-02-08 Last updated: 2019-05-21Bibliographically approved
Söderström, K., Nilsson, P., Laurell, G., Zackrisson, B. & Levring Jäghagen, E. (2017). Dysphagia - Results from multivariable predictive modelling on aspiration from a subset of the ARTSCAN trial. Radiotherapy and Oncology, 122(2), 192-199
Open this publication in new window or tab >>Dysphagia - Results from multivariable predictive modelling on aspiration from a subset of the ARTSCAN trial
Show others...
2017 (English)In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 122, no 2, p. 192-199Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To establish predictive models for late objective aspiration and late patient-reported choking based on dose-volume parameters and baseline patient and treatment characteristics, for patients with head and neck cancer undergoing definitive radiotherapy (RT). The impact of electively treated volume on late aspiration was also investigated.

METHODS AND MATERIAL: This prospective cohort is a subsample of 124 survivors from the ARTSCAN study. Late aspiration was identified with videofluoroscopy, at a minimum of 25months after the start of RT. Patient-reported choking was analysed at 12 and 60months post RT using the EORTC Quality of Life Module for Head and Neck Cancer 35. Univariable and multivariable analyses were performed to describe the association between clinical factors and dose-volume descriptors for organs at risk (OARs) and late dysphagia.

RESULTS: Aspiration was found in 47% of the eligible patients. Mean dose to the middle pharyngeal constrictor (MPC), neck dissection post RT and age at randomisation in ARTSCAN were associated to late aspiration. Mean dose to the superior pharyngeal constrictor (SPC) and swallowing complaints at baseline were associated to patient reported choking at both time-points.

CONCLUSIONS: Three separate risk groups for late aspiration, and two risk groups for late patient-reported choking were identified based on number of risk factors. The size of the electively treated volume could be used as a surrogate for individual OARs predicting late aspiration.

National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-126877 (URN)10.1016/j.radonc.2016.09.001 (DOI)000395607300004 ()27687824 (PubMedID)
Available from: 2016-10-18 Created: 2016-10-18 Last updated: 2018-06-09Bibliographically approved
Lindblom, U., Nilsson, P., Gärskog, O., Kjellen, E., Laurell, G., Wahlberg, P., . . . Levring Jäghagen, E. (2016). Aspiration as a late complication after accelerated versus conventional radiotherapy in patients with head and neck cancer. Acta Oto-Laryngologica, 136(3), 304-311
Open this publication in new window or tab >>Aspiration as a late complication after accelerated versus conventional radiotherapy in patients with head and neck cancer
Show others...
2016 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 136, no 3, p. 304-311Article in journal (Refereed) Published
Abstract [en]

Conclusion Neck dissection after radiotherapy increased the risk of aspiration as a late effect in a sub-sample of patients treated for head and neck cancer in the ARTSCAN study. Patients treated with accelerated fractionation (AF) developed aspiration, with or without coughing, more frequently than patients treated with conventional fractionation (CF). Objectives A long-term follow-up study was conducted to determine the frequency of aspiration as a late effect in patients with head and neck cancer treated with AF or CF. Method One-hundred and eight patients were recruited from two centres of the Swedish multi-centre study, ARTSCAN, where AF and CF were compared. Patients with positive lymph nodes were treated with neck dissection after completing radiotherapy. The follow-up was performed at a median of 65 months after initiation of radiotherapy and included an ENT and a videofluoroscopic examination. Results Aspiration was found in 51/108 (47%) and silent aspiration in 34/96 (35%) patients. Neck dissection (n = 47 patients) was significantly associated with both aspiration and silent aspiration. Aspiration was more common among patients treated with AF (34/61; 56%) compared to CF (17/47; 36%; p = 0.053). Silent aspiration was also more common after AF (24/54; 44%) than after CF (10/42; 24%; p = 0.052).

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keywords
Late effect, dysphagia, follow-up, neck dissection, sequelae, swallowing disorders, videofluoroscopy
National Category
Cancer and Oncology Otorhinolaryngology
Research subject
Oncology; Odontology; Radiology; radiofysik; Oto-Rhino-Laryngology
Identifiers
urn:nbn:se:umu:diva-115781 (URN)10.3109/00016489.2015.1113439 (DOI)000375933300017 ()26838580 (PubMedID)
Projects
ARTSCAN
Available from: 2016-02-04 Created: 2016-02-04 Last updated: 2018-06-07Bibliographically approved
Garoff, M., Ahlqvist, J., Levring Jäghagen, E., Johansson, E. & Wester, P. (2016). Carotid calcification in panoramic radiographs: radiographic appearance and the degree of carotid stenosis. Dento-Maxillo-Facial Radiology, 45(6), Article ID 20160147.
Open this publication in new window or tab >>Carotid calcification in panoramic radiographs: radiographic appearance and the degree of carotid stenosis
Show others...
2016 (English)In: Dento-Maxillo-Facial Radiology, ISSN 0250-832X, E-ISSN 1476-542X, Vol. 45, no 6, article id 20160147Article in journal (Refereed) Published
Abstract [en]

Objectives: Approximately 7% of patients examined with panoramic radiographs (PRs) for odontological reasons, and with incidental findings of carotid artery calcification (CAC), have significant (≥50%) carotid stenosis (SCS). The aim of this study was to determine if the radiographic appearance of CACs in PRs could be categorized such that we could improve the positive-predictive value (PPV) for SCS detection.

Methods: This cross-sectional study included 278 patients with CACs identified by PRs, 127 with SCS and 151 without SCS. CACs were categorized based on the following appearances: (1) single, (2) scattered or (3) vessel-outlining. Correlates were derived for each category according to positivity or not for SCS in the corresponding neck sides. For a representative adult population (in dentistry) presenting with CACs in PRs, PPVs for SCS prediction were then calculated for three subgroups based on different combinations of appearances (2) and/or (3).

Results: Vessel-outlining CACs corresponded to 65% of neck sides with SCS vs 47% without SCS (p < 0.001). Single CACs corresponded to 15% of neck sides with SCS vs 27% without SCS (p = 0.006). Scattered CACs corresponded to 20% of neck sides with SCS vs 26% without SCS (p  = 0.127). In the representative population, the PPVs for SCS detection were comparable (7.2–7.8%) for all three subgroups and when the presence of a CAC is the sole criterion (7.4%).

Conclusions: Stratifying the radiographic appearance of CACs in PRs does not improve the PPV for SCS detection. Whether different radiographic appearances are associated with future risk of stroke, or other cardiovascular events, remains unknown.

Place, publisher, year, edition, pages
British Institute of Radiology, 2016
Keywords
carotid stenosis, panoramic radiography, calcification
National Category
Dentistry Radiology, Nuclear Medicine and Medical Imaging
Research subject
Odontology
Identifiers
urn:nbn:se:umu:diva-119791 (URN)10.1259/dmfr.20160147 (DOI)000381711400003 ()
Note

First published in theses in manuscript form.

Available from: 2016-04-27 Created: 2016-04-27 Last updated: 2018-06-07Bibliographically approved
Holmlund, T., Franklin, K. A., Levring Jäghagen, E., Lindqvist, M., Larsson, T., Sahlin-Ingridsson, C. & Berggren, D. (2016). Tonsillectomy in adults with obstructive sleep apnea. The Laryngoscope, 126(12), 2859-2862
Open this publication in new window or tab >>Tonsillectomy in adults with obstructive sleep apnea
Show others...
2016 (English)In: The Laryngoscope, ISSN 0023-852X, E-ISSN 1531-4995, Vol. 126, no 12, p. 2859-2862Article in journal (Refereed) Published
Abstract [en]

Objectives/Hypothesis To study whether tonsillectomy is effective on obstructive sleep apnea (OSA) in adults with large tonsils. Study Design A multicenter prospective interventional study. Methods The study comprised 28 patients with OSA, an apnea-hypopnea index of > 10, large tonsils (Friedman tonsil size 3 and 4), and age 18 to 59 years. They were derived from 41 consecutive males and females with large tonsils referred for a suspicion of sleep apnea to the ear, nose, and throat departments in Umea, Skelleftea, and Sunderbyn in northern Sweden. The primary outcome was the apnea-hypopnea index, measured with polygraphic sleep apnea recordings 6 months after surgery. Secondary outcomes included daytime sleepiness, as measured with the Epworth Sleepiness Scale, and swallowing function, using video-fluoroscopy. Results The apnea-hypopnea index was reduced from a mean of 40 units per hour (95% confidence interval [CI] 28-51) to seven units per hour (95% CI 3-11), P < 0.001, at the 6-month follow-up after surgery. The apnea-hypopnea index was reduced in all patients and 18 (64%) were cured. The Epworth Sleepiness Scale was reduced from a mean of 11 (95% CI 8-13) to 6.0 (95% CI 4-7), P < 0.001. A swallowing dysfunction was found in seven of eight investigated patients before surgery. Of those, swallowing function improved in five patients after surgery, whereas no one deteriorated. Conclusion Tonsillectomy may be effective treatment for adult patients with OSA and large tonsils. Tonsillectomy may be suggested for adults with OSA and large tonsils. Level of Evidence 4.

Keywords
OSA, tonsilar hypertrophy, tonsillectomy
National Category
Otorhinolaryngology
Research subject
Oto-Rhino-Laryngology
Identifiers
urn:nbn:se:umu:diva-119020 (URN)10.1002/lary.26038 (DOI)000388602600048 ()27107408 (PubMedID)
Available from: 2016-04-07 Created: 2016-04-07 Last updated: 2018-06-07Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8807-3500

Search in DiVA

Show all publications