Abstract

In patients of oral cavity or oropharyngeal cancers, resection of the tumor and reconstruction of the defect may reduce the framework, add a bulky flap, alter the tissue flexibility, and contribute to postoperative obstructive sleep apnea (OSA). Postoperative OSA and the potential consequences may decrease the survival rate and reduce patients' quality of life. It is unclear whether the surgery is associated with postoperative OSA. Here, we compared the polysomnographies (PSGs) before and after the surgery in 15 patients of oral cavity or oropharyngeal cancers (out of 68 patients of head and neck cancers) without a chemo- or radio-therapy. Each patient received the second PSG before the start of any indicated adjuvant therapy to prevent its interference. There were 14 men and 1 woman, with a mean age and a standard deviation (SD, same in the following) of 56.2 ± 12.8 years. There were 6 tongue cancers, 5 buccal cancers, 2 tonsil cancer, 1 lower gum cancer, and 1 trigone cancer. The results show that the surgery changed sleep parameters insignificantly in apnea-hypopnea index (AHI), mean oxyhemoglobin saturation of pulse oximetry (SpO2), minimum SpO2, mean desaturation, and desaturation index but increased mean heart rate in the patients with free flaps. These results hint that the effect of surgery on developing OSA was small in this sample, with a longer plate or a larger framework for a bulkier free flap. It needs future studies with a large sample size to generalize this first observation.

Highlights

  • Surgery is a solution of treating oral cavity or oropharyngeal cancers

  • The results show that the resection and reconstruction surgeries did not alter sleep parameters significantly in AHI, mean SpO2, minimum SpO2, mean desaturation, and desaturation index in this sample

  • These sleep parameters did not differ in both free-flap and non-free-flap patients after the surgery

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Summary

Introduction

Surgery is a solution of treating oral cavity or oropharyngeal cancers. Surgery may contribute to OSA by restricting upper airway with bulky flap [1] or prosthetic [2, 3] reconstructions. Patients of oral cavity or oropharyngeal cancers undergoing a surgery reportedly have a higher prevalence of moderate to severe postoperative OSA, compared with a nonsurgical group [4]. The reported OSA associated procedures include partial glossectomy with radial forearm-free-flap reconstruction [5] and mandibulectomy without reconstruction [6]. These surgeries may reduce the framework anatomy, enlarge the content volume, or alter the tissue flexibility, and contribute to OSA

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