Ann Rehabil Med.  2013 Apr;37(2):175-182. 10.5535/arm.2013.37.2.175.

Videofluoroscopic Swallowing Study Findings in Full-Term and Preterm Infants With Dysphagia

• Uhm KE
• Yi SH
• Chang HJ
• Cheon HJ
• Kwon JY

• KMID: 2165768
• DOI: http://doi.org/10.5535/arm.2013.37.2.175

Abstract

OBJECTIVE
To determine the clinical characteristics and videofluoroscopic swallowing study (VFSS) findings in infants with suspected dysphagia and compare the clinical characteristics and VFSS findings between full-term and preterm infants.
METHODS
A total of 107 infants (67 full-term and 40 preterm) with suspected dysphagia who were referred for VFSS at a tertiary university hospital were enrolled in this retrospective study. Clinical characteristics and VFSS findings were reviewed by a physiatrist and an experienced speech-language pathologist. The association between the reasons of referral for VFSS and VFSS findings were analyzed.
RESULTS
Mean gestational age was 35.1+/-5.3 weeks, and mean birth weight was 2,381+/-1,026 g. The most common reason for VFSS referral was 'poor sucking' in full-term infants and 'desaturation' in preterm infants. The most common associated medical condition was 'congenital heart disease' in full-term infants and 'bronchopulmonary dysplasia' in preterm infants. Aspiration was observed in 42 infants (39.3%) and coughing was the only clinical predictor of aspiration in VFSS. However, 34 of 42 infants (81.0%) who showed aspiration exhibited silent aspiration during VFSS. There were no significant differences in the VFSS findings between the full-term and preterm infants except for 'decreased sustained sucking.'
CONCLUSION
There are some differences in the clinical manifestations and VFSS findings between full-term and preterm infants with suspected dysphagia. The present findings provide a better understanding of these differences and can help clarify the different pathophysiologic mechanisms of dysphagia in infants.

Keyword

Fluoroscopy; Dysphagia; Infant; Premature; Term birth

MeSH Terms

Birth Weight
Cough
Deglutition
Deglutition Disorders
Fluoroscopy
Gestational Age
Heart
Humans
Infant
Infant, Newborn
Infant, Premature
Referral and Consultation
Retrospective Studies
Term Birth

Reference

1. Delaney AL, Arvedson JC. Development of swallowing and feeding: prenatal through first year of life. Dev Disabil Res Rev. 2008; 14:105–117. PMID: 18646020.

2. Bu'Lock F, Woolridge MW, Baum JD. Development of co-ordination of sucking, swallowing and breathing: ultrasound study of term and preterm infants. Dev Med Child Neurol. 1990; 32:669–678. PMID: 2210082.

3. Newman LA, Keckley C, Petersen MC, Hamner A. Swallowing function and medical diagnoses in infants suspected of Dysphagia. Pediatrics. 2001; 108:E106. PMID: 11731633.

4. Arvedson J, Clark H, Lazarus C, Schooling T, Frymark T. Evidence-based systematic review: effects of oral motor interventions on feeding and swallowing in preterm infants. Am J Speech Lang Pathol. 2010; 19:321–340. PMID: 20622046.

5. Mercado-Deane MG, Burton EM, Harlow SA, Glover AS, Deane DA, Guill MF, et al. Swallowing dysfunction in infants less than 1 year of age. Pediatr Radiol. 2001; 31:423–428. PMID: 11436889.

6. Lee JH, Chang YS, Yoo HS, Ahn SY, Seo HJ, Choi SH, et al. Swallowing dysfunction in very low birth weight infants with oral feeding desaturation. World J Pediatr. 2011; 7:337–343. PMID: 22015726.

7. Kim TU, Park WB, Byun SH, Lee MJ, Lee SJ. Videofluoroscopic findings in infants with aspiration symptom. J Korean Acad Rehabil Med. 2009; 33:348–352.

8. Logemann JA. Evaluation and treatment of swallowing disorders. 1998. 2nd ed. San Diego: College Hill Press;p. 168–180.

9. Hack M, Estabrook MM, Robertson SS. Development of sucking rhythm in preterm infants. Early Hum Dev. 1985; 11:133–140. PMID: 4029050.

10. McGrath JM, Braescu AV. State of the science: feeding readiness in the preterm infant. J Perinat Neonatal Nurs. 2004; 18:353–368. PMID: 15646306.

11. Medoff-Cooper B, McGrath JM, Bilker W. Nutritive sucking and neurobehavioral development in preterm infants from 34 weeks PCA to term. MCN Am J Matern Child Nurs. 2000; 25:64–70. PMID: 10748582.

12. Medoff-Cooper B, McGrath JM, Shults J. Feeding patterns of full-term and preterm infants at forty weeks postconceptional age. J Dev Behav Pediatr. 2002; 23:231–236. PMID: 12177569.

13. Hanlon MB, Tripp JH, Ellis RE, Flack FC, Selley WG, Shoesmith HJ. Deglutition apnoea as indicator of maturation of suckle feeding in bottle-fed preterm infants. Dev Med Child Neurol. 1997; 39:534–542. PMID: 9295849.

14. Arvedson J, Rogers B, Buck G, Smart P, Msall M. Silent aspiration prominent in children with dysphagia. Int J Pediatr Otorhinolaryngol. 1994; 28:173–181. PMID: 8157416.

15. Hiorns MP, Ryan MM. Current practice in paediatric videofluoroscopy. Pediatr Radiol. 2006; 36:911–919. PMID: 16552584.

16. Karkos PD, Papouliakos S, Karkos CD, Theochari EG. Current evaluation of the dysphagic patient. Hippokratia. 2009; 13:141–146. PMID: 19918301.

17. Lefton-Greif MA. Pediatric dysphagia. Phys Med Rehabil Clin N Am. 2008; 19:837–851. PMID: 18940644.

18. Prasse JE, Kikano GE. An overview of pediatric dysphagia. Clin Pediatr (Phila). 2009; 48:247–251. PMID: 19023104.

19. Chung SH, Beck NS, Lee M, Lee SI, Lee HJ, Choe JY, et al. Clinical manifestations of dysphagia in children. J Korean Pediatr Soc. 1999; 42:60–68.

20. Newman LA, Cleveland RH, Blickman JG, Hillman RE, Jaramillo D. Videofluoroscopic analysis of the infant swallow. Invest Radiol. 1991; 26:870–873. PMID: 1960027.