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Dysphagia in healthy children: Characteristics and management of a consecutive cohort at a tertiary centre.

Abstract Whereas the literature is replete with reports on complex children with dysphagia (DP), the parameters characterizing non-neurologically impaired (NNI) children have been underreported, leaving a substantial knowledge gap. We set to characterize a consecutive cohort of NNI children, their management, and outcomes.
PMID
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Authors

Mayor MeshTerms
Keywords

Airway

Dysphagia

Laryngoscopy

Larynx

Pediatric

Swallowing

Journal Title international journal of pediatric otorhinolaryngology
Publication Year Start




PMID- 28688566
OWN - NLM
STAT- MEDLINE
DA  - 20170709
DCOM- 20170803
LR  - 20170803
IS  - 1872-8464 (Electronic)
IS  - 0165-5876 (Linking)
VI  - 99
DP  - 2017 Aug
TI  - Dysphagia in healthy children: Characteristics and management of a consecutive
      cohort at a tertiary centre.
PG  - 54-59
LID - S0165-5876(17)30243-4 [pii]
LID - 10.1016/j.ijporl.2017.05.024 [doi]
AB  - OBJECTIVE: Whereas the literature is replete with reports on complex children
      with dysphagia (DP), the parameters characterizing non-neurologically impaired
      (NNI) children have been underreported, leaving a substantial knowledge gap. We
      set to characterize a consecutive cohort of NNI children, their management, and
      outcomes. METHODS: We undertook a retrospective case series. Children (<18 years 
      old) attending a tertiary multidisciplinary swallowing clinic were eligible.
      Patients with neuro-developmental, neuromuscular, or syndromic abnormalities were
      excluded. Primary outcomes included demographics, co-morbidities, presentations, 
      McGill score, swallowing and airway abnormalities (and their predictors).
      Secondary outcomes were interventions and management response. RESULTS: From 171 
      consecutive patients (37-month period), 128 were included (69 males, median age
      6.6 months (0.5-124.2)). Significant clinical presentations included recurrent
      pneumonias (20), cyanotic spells (14) and life-threatening events (10).
      Swallowing assessments revealed laryngeal penetration (67), aspiration (25).
      Other investigations included overnight oximetry (77), airway (70), and
      gastrointestinal endoscopy (24); revealing laryngomalacia (29), laryngeal
      mobility disorder (8), and subglottic stenosis (8). Non-surgical interventions
      involved oral diet modifications (85) and enteral nutrition (15). Surgical
      interventions included supraglottoplasties (18), endoscopic laryngeal cleft
      repair (14), and injection (19). 119 patients received intervention and at last
      follow-up (median 5.2 months (0.3-88.8)) 94 had improved. Of those treated 116
      were on an unmodified oral diet, and 24 on a modified diet. ALTE and snoring
      predicted airway abnormalities, recurrent pneumonia predicted swallowing
      abnormalities, and age and airway lesions predicted the McGill score. CONCLUSION:
      a significant proportion of NNI children with DP harbor airway and swallowing
      abnormalities warranting endoscopic and instrumental assessment.
CI  - Copyright (c) 2017 Elsevier B.V. All rights reserved.
FAU - Svystun, Orysya
AU  - Svystun O
AD  - Pediatric Otolaryngology, Divisions of Otolaryngology - Head & Neck Surgery,
      Departments of Surgery & Pediatrics, The Stollery Children's Hospital, Edmonton, 
      Alberta, Canada.
FAU - Johannsen, Wendy
AU  - Johannsen W
AD  - Outpatient Feeding & Swallowing Service, Departments of Surgery & Pediatrics, The
      Stollery Children's Hospital, Edmonton, Alberta, Canada.
FAU - Persad, Rabin
AU  - Persad R
AD  - Pediatric Gastroenterology, Departments of Surgery & Pediatrics, The Stollery
      Children's Hospital, Edmonton, Alberta, Canada.
FAU - Turner, Justine M
AU  - Turner JM
AD  - Pediatric Gastroenterology, Departments of Surgery & Pediatrics, The Stollery
      Children's Hospital, Edmonton, Alberta, Canada.
FAU - Majaesic, Carina
AU  - Majaesic C
AD  - Pediatric Pulmonology, Departments of Surgery & Pediatrics, The Stollery
      Children's Hospital, Edmonton, Alberta, Canada.
FAU - El-Hakim, Hamdy
AU  - El-Hakim H
AD  - Pediatric Otolaryngology, Divisions of Otolaryngology - Head & Neck Surgery,
      Departments of Surgery & Pediatrics, The Stollery Children's Hospital, Edmonton, 
      Alberta, Canada. Electronic address: [email protected]
LA  - eng
PT  - Journal Article
DEP - 20170530
PL  - Ireland
TA  - Int J Pediatr Otorhinolaryngol
JT  - International journal of pediatric otorhinolaryngology
JID - 8003603
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Deglutition/*physiology
MH  - Deglutition Disorders/*complications/diagnosis/therapy
MH  - Endoscopy/methods
MH  - Female
MH  - Fluoroscopy/methods
MH  - Humans
MH  - Infant
MH  - Male
MH  - Retrospective Studies
MH  - Tertiary Care Centers
OTO - NOTNLM
OT  - Airway
OT  - Dysphagia
OT  - Laryngoscopy
OT  - Larynx
OT  - Pediatric
OT  - Swallowing
EDAT- 2017/07/10 06:00
MHDA- 2017/08/05 06:00
CRDT- 2017/07/10 06:00
PHST- 2017/04/26 [received]
PHST- 2017/05/27 [accepted]
AID - S0165-5876(17)30243-4 [pii]
AID - 10.1016/j.ijporl.2017.05.024 [doi]
PST - ppublish
SO  - Int J Pediatr Otorhinolaryngol. 2017 Aug;99:54-59. doi:
      10.1016/j.ijporl.2017.05.024. Epub 2017 May 30.