Changes in symptom scales of laryngopharyngeal reflux following obstructive sleep apnea surgery: A systematic review and meta-analysis

Authors

• Chung-Wei Lin, Department of Otolaryngology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Department of Otolaryngology, Robotic Surgery Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
• Yu-Han Wang, Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan.
• Hsin-Ching Lin, Department of Otolaryngology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Department of Otolaryngology, Robotic Surgery Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; College of Medicine, Chang Gung University, Taoyuan and Kaohsiung, Taiwan; Sleep Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Department of Business Management, Institute of Healthcare Management, National Sun Yat-sen University, Kaohsiung, Taiwan; College of Medicine and Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan. Electronic address: enthclin@aol.com.
• Chun-Tuan Chang, Department of Business Management, Institute of Healthcare Management, National Sun Yat-sen University, Kaohsiung, Taiwan.
• Michael Friedman, Advocate Health - MidwestFollow
• Anna M. Salapatas, Advocate Health - Midwest

Recommended Citation

Lin CW, Wang YH, Lin HC, Chang CT, Friedman M, Salapatas AM. Changes in Symptom Scales of Laryngopharyngeal Reflux Following Obstructive Sleep Apnea Surgery: A Systematic Review and Meta-Analysis. J Voice. Published online May 8, 2026. doi:10.1016/j.jvoice.2026.04.018

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Obstructive sleep apnea (OSA) is a serious health concern having been associated with laryngopharyngeal reflux (LPR), but the impact of OSA treatment, particularly sleep surgery, on LPR has not yet been fully investigated. This study aims to comprehensively analyze the current available literature to study the impact of soft tissue sleep surgery on LPR manifestations and symptoms in patients with OSA. Six databases, including PubMed, Embase, ScienceDirect, Cochrane Library, Web of Science, and Scopus, were systematically searched. Studies focusing on changes of LPR symptom scales, including Reflux Symptom Index (RSI) and Reflux Finding Score (RFS), before and after upper airway sleep surgery were included. Qualitative and quantitative analyses of the literature and different modalities were performed. Six studies with 278 patients were enrolled eventually. After surgery, most of the LPR symptom parameters improved. The meta-analysis further showed that in changes of RSI, "difficulty breathing" showed the largest effect of improvement (Hedge's g: -1.21 (95% confidence interval (CI): -1.84 to -0.58)). In changes of RFS, "diffuse laryngeal edema" achieved the largest improvement (Hedge's g: -1.30 (95% CI: -2.51 to -0.09)) postoperatively. The findings potentially indicated that LPR symptoms could relieve following OSA surgery, especially in certain symptom domains, and better postoperative respiratory status may have the potential to alleviate acute inflammation and the severity of LPR.

Document Type

Article

PubMed ID

42106305