Obstructive Sleep Apnea in Patients With Oral and Oropharyngeal Cancer Undergoing Free Flap Reconstruction: A Longitudinal Study With Computed Tomography

ABSTRACT Background Obstructive sleep apnea (OSA) often worsens in head and neck cancer patients post‐treatment. Its relationship with airway morphology after free flap reconstruction in oral/oropharyngeal cancer (OOC) remains unclear. This study longitudinally explored OSA severity and airway changes in OOC patients post‐reconstruction. Methods Twenty six male OOC patients underwent polysomnography and head/neck computed tomography scans before, 1 week after, and 6 months after free flap reconstruction. Airway volume/dimensions and OSA parameters were analyzed. Results Upper airway volume, neck size, and total apnea‐hypopnea index (AHI) significantly increased 1‐week post‐surgery. At 6 months, only the total AHI increase remained significant. Upper airway volume was found to have a positive influence on AHI. Conclusion OSA worsened after free flap reconstruction with partial recovery by 6 months. Airway dimensions may play a different role in these patients than general OSA populations, warranting more aggressive OSA screening in this cohort.