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Type: Journal article
Title: Objective assessment of swallow function in children with suspected aspiration using pharyngeal automated impedance manometry
Author: Rommel, N.
Selleslagh, M.
Hoffman, I.
Smet, M.
Davidson, G.
Tack, J.
Omari, T.
Citation: Journal of Pediatric Gastroenterology and Nutrition, 2014; 58(6):789-794
Publisher: Lippincott Williams & Wilkins
Issue Date: 2014
ISSN: 0277-2116
Statement of
Nathalie Rommel, Margot Selleslagh, Ilse Hoffman, Maria H. Smet, Geoffrey Davidson, Jan Tack, Taher Imad Omari
Abstract: OBJECTIVES: The purpose of the present study was to apply a new method, pharyngeal automated impedance manometry (AIM), as an objective assessment tool of swallow function relevant to aspiration, in a cohort of paediatric patients with dysphagia. METHODS: We studied 20 children (mean age 6 years [5 months to 13.4 years]) referred for videofluoroscopy to assess aspiration risk with simultaneous manometry-impedance. Fluoroscopic evidence of aspiration was scored using a validated aspiration-penetration score. Pressure-flow profiles were analysed using AIM analysis measuring peak pressure, pressure at nadir impedance, time from nadir impedance to peak pressure, and flow interval. These variables were combined into a swallow risk index (SRI). RESULTS: Six of 20 children presented with deglutitive aspiration during videofluoroscopic assessment of swallowing. Of 58 liquid swallows analysed, in 9 aspiration was observed. Multiple logistic regression identified longer flow interval (P < 0.05), higher SRI (P < 0.05) and increased pressure in the upper oesophageal sphincter during maximal bolus flow (P < 0.05) to be the dominant risk variables predictive of aspiration in children. Each of these nonradiologically derived pressure-flow variables correlated with higher aspiration scores on videofluoroscopy (P < 0.01). CONCLUSIONS: We present novel, preliminary findings in children with deglutitive aspiration, suggesting that pharyngeal AIM can detect alterations in pressure-flow characteristics of swallowing that predispose to aspiration risk.
Keywords: Esophageal Sphincter, Upper
Deglutition Disorders
Logistic Models
Electric Impedance
Rights: Copyright status unknown
DOI: 10.1097/MPG.0000000000000337
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