Objective assessment of swallow function in children with suspected aspiration using pharyngeal automated impedance manometry

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dc.contributor.authorRommel, N.
dc.contributor.authorSelleslagh, M.
dc.contributor.authorHoffman, I.
dc.contributor.authorSmet, M.
dc.contributor.authorDavidson, G.
dc.contributor.authorTack, J.
dc.contributor.authorOmari, T.
dc.date.issued2014
dc.description.abstractOBJECTIVES: 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.
dc.description.statementofresponsibilityNathalie Rommel, Margot Selleslagh, Ilse Hoffman, Maria H. Smet, Geoffrey Davidson, Jan Tack, Taher Imad Omari
dc.identifier.citationJournal of Pediatric Gastroenterology and Nutrition, 2014; 58(6):789-794
dc.identifier.doi10.1097/MPG.0000000000000337
dc.identifier.issn0277-2116
dc.identifier.issn1536-4801
dc.identifier.orcidOmari, T. [0000-0001-5108-7378]
dc.identifier.urihttp://hdl.handle.net/2440/97626
dc.language.isoen
dc.publisherLippincott Williams & Wilkins
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1009344
dc.rightsCopyright status unknown
dc.source.urihttps://doi.org/10.1097/mpg.0000000000000337
dc.subjectEsophageal Sphincter, Upper
dc.subjectPharynx
dc.subjectDeglutition Disorders
dc.subjectFluoroscopy
dc.subjectLogistic Models
dc.subjectManometry
dc.subjectElectric Impedance
dc.subjectDeglutition
dc.titleObjective assessment of swallow function in children with suspected aspiration using pharyngeal automated impedance manometry
dc.typeJournal article
pubs.publication-statusPublished

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