Post-operative oropharyngeal rehabilitation suppress oxidative stress and inflammation in obstructive sleep apnea patients with transoral robotic surgery

Abstract

PURPOSE: To demonstrate the effects of postoperative oropharyngeal rehabilitation on inflammatory mediators and antioxidant capacity in adults with obstructive sleep apnea. METHODS: This quasi-experimental study enrolled participants without blinding between January 2020 and December 2022. Patients with obstructive sleep apnea were divided into a conservative treatment group (n = 17), surgery group (n = 23), or surgery combined with oropharyngeal rehabilitation (surgery + rehabilitation) group (n = 19). Polysomnography data and the concentration of inflammatory mediators and antioxidant capacity were determined at baseline, after 6 weeks of treatment, and after 18 weeks of treatment. RESULTS: Posttreatment percent changes in the apnea-hypopnea index in rapid eye movement sleep were positively correlated with that of IL-6 (0.641, 95% CI: 0.598 to 0.685; P < 0.001). Compared with the patients in the control group, those in the surgery + rehabilitation group had significantly reduced posttreatment percent changes in IL-6 (-77.273, 95% CI: -144.580 to -9.966; P = 0.024). In addition, the concentrations of IL-6 (-3.423, 95% CI: -6.638 to -0.207; P = 0.037) and matrix metallopeptidase-9 (-20.517, 95% CI: -40.584 to -0.450; P = 0.045) significantly decreased in the surgery + rehabilitation group. The total antioxidant capacity significantly improved in the surgery + rehabilitation group compared with in the surgery-only group (0.034, 95% CI: 0.005 to 0.063; P = 0.020). CONCLUSION: The results reveal that postoperative oropharyngeal rehabilitation can reduce the serum levels of inflammatory mediators and increase antioxidant capacity. The combined treatment is more effective than surgery-only or conservative treatment.