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|Title:||Objective assessment of swallow function in children with suspected aspiration using pharyngeal automated impedance manometry|
|Citation:||Journal of Pediatric Gastroenterology and Nutrition, 2014; 58(6):789-794|
|Publisher:||Lippincott Williams & Wilkins|
|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|
|Rights:||Copyright status unknown|
|Appears in Collections:||Aurora harvest 7|
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