Charakterystyka kliniczna i wyniki wideofluoroskopowej oceny aktu połykania u dzieci z zaburzeniami połykania
Journal Title: Postępy Nauk Medycznych - Year 2014, Vol 27, Issue 3
Abstract
Introduction. Swallowing disorders are a relevant but often unrecognized and underestimated problem in children. Sometimes they lead to aspiration pneumonia.Aim. The aim of this study was to show the usefulness of the videofluoroscopic swallowing studies’ (VFSS) findings in children with various diseases and symptoms of swallowing disorders based on experiences of the Department of Gastroenterology, Hepatology and Nutrition Disorders in Poland.Material and methods. A total of 36 children were enrolled in this retrospective study. All patients presented swallowing disorders, therefore they were referred to VFSS. Indications for VFSS were defined by a physician and speech-language pathologist. The outcomes were reviewed by a radiologist and speech-language pathologist. Type of feeding, compensation or rehabilitation was recommended by speech-language pathologist. The swallowing problems, VFSS findings and recommendation after examination were analyzed.Results. The reason for VFSS referral was “the safety of swallowing” (17 children) or the assessment the function of swallowing (15 children). For the rest of patients the reason for VFSS was the simultaneous evaluation of the safety and function of swallowing (4 children). 22 children (61%) presented with respiratory symptoms as a cause of swallowing disorders and the necessity for VFSS. Silent aspiration was observed in 15 of patients, aspiration with cough in 2, pharyngeal residue in 6, residue with penetration in 6 of all patients. The VFSS outcomes indicated the necessity to modify oral feeding in 19 children (53%). In 12 patients (33%) oral feeding was discontinued. Rehabilitation without oral feeding was ordered in 13 patient (36%), general swallowing rehabilitation with the oral use of foods in 11 children (30%). Compensation using different food consistency was used in 9 patient (25%), compensation by proper positioning and modified feeding technique was adopted in 16 children (44%). Feeding disorders therapy was ordered in 8 children (22%).Conclusions. This method is helpful for defining and diagnosis the problem with swallowing. VFSS allows to choose a proper therapy and to determine the way of feeding accordingly to different pathophysiologic mechanisms of swallowing disorders in children.
Authors and Affiliations
Ewa Winnicka, Dorota Majak, Anna Rybak
Keywords
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