Swallow Function Following Tongue Base Suspension: A Retrospective Evaluation of Dysphagia Risk

Introduction: Tongue base suspension is a surgical technique utilized to address obstructive sleep apnea (OSA), primarily in patients with glossoptosis. Given the tongue's central role in oropharyngeal swallowing, risks remain about potential postoperative dysphagia. This study aimed to evaluate the impact of tongue base suspension on swallowing mechanisms through postoperative swallow studies.

Methods: A retrospective chart review was conducted at a tertiary care center from 2019 to 2024 of pediatric patients who underwent fluoroscopic-assisted tongue base suspension (FATS) for the management of OSA. All patients included in this study underwent both a preoperative and postoperative videofluoroscopic swallow study (VFSS) within 6 months after surgery. Swallow function was evaluated across key domains, including oral bolus propulsion, pharyngeal clearance, laryngeal elevation, airway protection, and upper esophageal sphincter (UES) opening.

Results: Among the 17 patients who underwent postoperative swallow studies, none demonstrated new or worsened dysphagia. Swallow studies showed intact oral transit, effective tongue base retraction, preserved laryngeal elevation, timely airway closure, and normal UES function. No aspiration or penetration events were observed. The average time to completion of swallow study 54 days postoperatively.

Conclusions: Tongue base suspension does not adversely impact swallowing mechanisms in pediatric patients. Despite anatomical manipulation of the tongue base, key components of the swallow, including bolus control, airway protection, and pharyngeal clearance, remain preserved. These findings support the safety of tongue base suspension with respect to swallow function.