Ann Rehabil Med.  2014 Dec;38(6):734-741. 10.5535/arm.2014.38.6.734.

Clinical Characteristics Associated With Aspiration or Penetration in Children With Swallowing Problem

• Bae SO
• Lee GP
• Seo HG
• Oh BM
• Han TR

• KMID: 2267082
• DOI: http://doi.org/10.5535/arm.2014.38.6.734

Abstract

OBJECTIVE
To evaluate demographic characteristics of children with suspected dysphagia who underwent videofluoroscopic swallowing study (VFSS) and to identify factors related to penetration or aspiration.
METHODS
Medical records of 352 children (197 boys, 155 girls) with suspected dysphagia who were referred for VFSS were reviewed retrospectively. Clinical characteristics and VFSS findings were analyzed using univariate and multivariate analyses.
RESULTS
Almost half of the subjects (n=175, 49%) were under 24 months of age with 62 subjects (18%) born prematurely. The most common condition associated with suspected dysphagia was central nervous system (CNS) disease. Seizure was the most common CNS disorder in children of 6 months old or younger. Brain tumor was the most important one for school-age children. Aspiration symptoms or signs were the major cause of referral for VFSS in children except for infants of 6 months old or where half of the subjects showed poor oral intake. Penetration or aspiration was observed in 206 of 352 children (59%). Subjects under two years of age who were born prematurely at less than 34 weeks of gestation were significantly (p=0.026) more likely to show penetration or aspiration. Subjects with congenital disorder with swallow-related anatomical abnormalities had a higher percentage of penetration or aspiration with marginal statistical significance (p=0.074). Multivariate logistic regression analysis revealed that age under 24 months and an unclear etiology for dysphagia were factors associated with penetration or aspiration.
CONCLUSION
Subjects with dysphagia in age group under 24 months with preterm history and unclear etiology for dysphagia may require VFSS. The most common condition associated with dysphagia in children was CNS disease.

Keyword

Fluoroscopy; Pediatrics; Dysphagia; Premature infant; Aspiration pneumonia

MeSH Terms

Brain Neoplasms
Central Nervous System
Central Nervous System Diseases
Child*
Congenital, Hereditary, and Neonatal Diseases and Abnormalities
Deglutition Disorders
Deglutition*
Fluoroscopy
Humans
Infant
Infant, Newborn
Infant, Premature
Logistic Models
Medical Records
Multivariate Analysis
Pediatrics
Pneumonia, Aspiration
Pregnancy
Referral and Consultation
Retrospective Studies
Seizures

Figure

• 

  Fig. 1 Reason of referral for videofluoroscopic swallowing study. Nearly half of patients (174/352, 49.4%) complained of aspiration symptoms or signs. In age groups younger than 6 months, poor oral intake was the major complaint.

• 

  Fig. 2 Proportion of underlying medical conditions in specific age groups. Central nervous system disease was the most common cause of dysphagia in children with an increased tendency in groups of older children. Among children younger than 6 months of age, congenital disorder with swallow-related anatomical abnormalities (11/72, 15.3%) and neuromuscular disease (11/72, 15.3%) formed a considerable portion of the underlying conditions.

• 

  Fig. 3 Frequency distribution of subsets involving central nervous system diseases. The most prevalent disease in subjects younger than 6 months was seizure (9/21, 42.9%). Brain tumor was the leading disease in groups of older children (2 to 18 years of age).

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