VIDEOFLUOROSCOPIC SWALLOW STUDY IN CHILDREN WITH DYSPHAGIA

Introduction and Pourpose Infancy and childhood represent a time of unparalleled physical growth and cognitive development. In order for infants and children to reach their linear and neurological growth potential, they must be able to reliably and safely consume sufficient energy and nutrients. The prevalence of feeding problems has been estimated to be from 33% to 80% in children with developmental disorders. Approximately 37% to 40% of children assessed for feeding and swallowing disorders were born prematurely at less than 37 weeks of gestation. Increased survival rates of children with histories of prematurity, low birth weights, and complex medical conditions might explain the recent increase of pediatric dysphagia. Premature surviving patients, chronic illness, and psychological conditions are all possible causes of dysphagia in children. Swallowing difficulties in pediatric populations can have an adverse impact on pulmonary health. Dysphagia in pediatric populations can have a detrimental effect on dietary intake and, thus, growth and development. As a result, it is imperative to accurately identify and appropriately manage dysphagia in pediatric populations. These complex patients require a multidisciplinary approach that includes clinical and instrumental evaluations. The videofluoroscopic swallow study (VFSS) is a well established radiological technique largely used in adult population. VFSS in children of a referral center for dysphagia is herein reported. 288 patients, mean age 9 years (range: 2-18) underwent VFSS. In 185 cases (64%) macro silent aspiration (fig.1-2) or macro silent aspiration and GERD (Fig. 3-4), was evident and patients scheduled for gastro/ digiunostomy and, if necessary, fundoplication (fig. 9,10,11,12); in 45 (16%) only micro silent aspiration (Fig. 5-6) or micro silent aspiration and GERD (Fig. 7-8), was detected and patients directed to a rehabilitation trial, and in 58 cases (20%) no aspiration and patients sent to speech therapist. No complications occurred, although in 6 cases (0,74%) VFSS could not be completed due to demonstration of massive aspiration. Results VFSS swallowing study was performed with personal protocol. Dysphagic patients, aged