Aspiration in the otherwise healthy Infant—Is there a natural course for improvement?

Casazza, Geoffrey C.; Graham, M. Elise; Asfour, Fadi; O’Gorman, Molly; Skirko, Jonathan R.

doi:10.1002/lary.27888

Cited by 24 publications

(26 citation statements)

References 30 publications

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“…However, one series of 13 typically developing infants presenting with respiratory symptoms found all had resolved in just 3 to 9 months after starting thickened feeds, which is surprisingly fast from our experience 7 . A larger series of 50 otherwise typically developing infants found the probability of resolution was 46% at 6 months, 64% at 1 year, and 76% at 2 years 10 . Another series of 19 children with isolated dysphagia and without apparent risk factors found on follow‐up that 3 out of 14 still had swallowing problems aged 9 to 14 years, whilst 11 out of 14 had resolved at 8 months to 10 years of age (mean 3y 2mo) 9 …”

Section: Discussionmentioning

confidence: 56%

Isolated bulbar palsy and dysphagia in children with respiratory symptoms

Zimmels

Balfour‐Lynn

Christodoulou

et al. 2021

Develop Med Child Neuro

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Oropharyngeal dysphagia can cause chronic aspiration leading to significant respiratory symptoms. When dysphagia is diagnosed, an underlying cause is sought. We present a case series of 15 children diagnosed aged 6 months to 5 years (mean 2y 5mo; 11 males, four females) over a 6‐year period, who were found to have an isolated bulbar palsy on genioglossus electromyography, with no accompanying neurological or neurodevelopmental disorder. Eight children had dysphagia but a normal EMG. In those with isolated bulbar palsy, management included thickened fluids (n=13), cooled boiled water (n=1), and nasogastric tube feeding (n=1). Follow‐up over 1 to 8 years (mean 5y) showed complete resolution in six children, improvement in four children, and no improvement in five children (including two requiring fluids via a gastrostomy). Eight children no longer had any respiratory symptoms. Isolated bulbar palsy is under‐recognized and has not been reported previously as a cause of significant dysphagia in children.

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Section: Discussionmentioning

confidence: 56%

Isolated bulbar palsy and dysphagia in children with respiratory symptoms

Zimmels

Balfour‐Lynn

Christodoulou

et al. 2021

Develop Med Child Neuro

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“…Therefore, the authors suggest that nasogastric feed should be started while adopting precautionary measures. These precautionary measures include the upright position of the patient, elevating the patient's head end by 30 degrees, avoiding nasogastric tube feeding before going to sleep, and elevating the head of the patient after feeding [ 15 ]. In this way, we can improve the surgical outcome by preventing or decreasing the frequency of chemical pneumonitis during the postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Cervical Cystic Teratoma: An Unusual Cause of Airway Obstruction in the Pediatric Population

Azam¹,

Hanif²,

Khan³

et al. 2021

Cureus

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Cystic teratoma is a germ cell tumor, which usually involves the gonads. However, it can be located occasionally in other organs. The most common extragonadal sites for germ cell tumors include midline structures such as the retroperitoneum, mediastinum, pineal body, and supra-sellar space. Here, we describe a case of a patient who presented with a cystic teratoma involving the anterior aspect of the neck. The chief complaints of the patient consisted of a large swelling in front of the neck, difficulty in breathing, and frequent regurgitation of milk during feeding. Initially, a diagnosis of cystic hygroma was instituted for which the patient underwent sclerotherapy utilizing bleomycin. However, no improvement was observed in the patient’s condition. A detailed evaluation was planned, starting with a CT scan of the head and neck that suggested cystic teratoma as the likely etiology. Surgical excision of the mass was performed, and an excisional biopsy for histopathological examination was taken. A final diagnosis of cervical cystic teratoma was established based on the histopathological findings. The purpose of reporting this case is to raise awareness among fellow healthcare professionals that cystic teratoma can also present with a large swelling in the anterior neck with obstructive features.

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“…The OHITs in previous case series were all diagnosed with SwD during the first 2 years of life. 7,8,9,27,28 The median/mean age at diagnosis was reported to be, respectively, 2 ± 1.6 months, 6.6 months (range, 3.1-17.1 months), and 1.14 years (range, 0.9-5.75). 7,27,28 However, the documented mean age at surgical intervention (ie, laryngeal cleft repair or injection laryngoplasty) was 24.7 months (range, 4-63 months), 25.3 months (range, 2-120 months), and 1.6 years, respectively.…”

Section: Discussionmentioning

confidence: 99%

Parent‐Reported Outcome Questionnaire for Swallowing Dysfunction in Healthy Infants and Toddlers: Construction and Content Validation

Baqays

Johannsen

Rashid

et al. 2020

Otolaryngol.--head neck surg.

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Objectives There is limited epidemiological information on swallowing dysfunction (SwD) in otherwise healthy infants and toddlers (OHITs). Cost, invasiveness, expertise, and resources constrain the repeatability and utility of instrumental diagnostic tests. A parent-reported outcomes (PRO) tool has the potential to mitigate these disadvantages. Hence, we set out to develop and validate a novel PRO tool to assess SwD in OHITs. Study Design A mixed-method study. Setting Tertiary pediatric center. Methods We recruited parents of OHITs with SwD and excluded those with a confounding diagnosis (syndromes or neurological impairment). Interviews were conducted and thematically analyzed to extract the relevant domains and items. A similar analytical method was performed on the reports from a systematic review and literature search. Four verification sessions of parents and experts were conducted to maintain rigor. A panel of experts assessed and established the content validity of the items using a modified Delphi technique. Results We achieved information saturation after interviewing 10 parents and generated 7 domains with 72 items. Over the course of 3 rounds of modified Delphi content validation, the domains were reduced to 3 (swallowing, breathing, and illness) containing 21 items; a content validity index of 82.1% was achieved. Conclusion We validated the content of a new PRO instrument to assess SwD in OHITs. The instrument is composed of 3 primary domains representing 21 items. This tool has the potential to screen for swallowing dysfunction and can assess management outcomes specifically for this population at a community level.

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Aspiration in the otherwise healthy Infant—Is there a natural course for improvement?

Cited by 24 publications

References 30 publications

Isolated bulbar palsy and dysphagia in children with respiratory symptoms

Isolated bulbar palsy and dysphagia in children with respiratory symptoms

Cervical Cystic Teratoma: An Unusual Cause of Airway Obstruction in the Pediatric Population

Parent‐Reported Outcome Questionnaire for Swallowing Dysfunction in Healthy Infants and Toddlers: Construction and Content Validation

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