Rommel, N.Selleslagh, M.Hoffman, I.Smet, M.Davidson, G.Tack, J.Omari, T.2016-01-052016-01-052014Journal of Pediatric Gastroenterology and Nutrition, 2014; 58(6):789-7940277-21161536-4801http://hdl.handle.net/2440/97626OBJECTIVES: 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.enCopyright status unknownEsophageal Sphincter, UpperPharynxDeglutition DisordersFluoroscopyLogistic ModelsManometryElectric ImpedanceDeglutitionJournal article003002875710.1097/MPG.00000000000003370003362616000292-s2.0-84901595728114389Omari, T. [0000-0001-5108-7378]