Evaluation of Swallow Function in Patients with Craniofacial Microsomia: A Retrospective Study

Abstract

Craniofacial microsomia (CFM) is characterized by underdevelopment of the structures derived from the first and second pharyngeal arches resulting in aesthetic, psychological, and functional problems including feeding and swallowing difficulties. The aim of this study is to gain more insight into swallowing difficulties in patients with CFM. A retrospective study was conducted in the population of patients diagnosed with CFM at three major craniofacial units. Patients with feeding difficulties and those who underwent video fluoroscopic swallow (VFS) studies were included for further analyses. The outcome of the VFS-studies was reviewed with regard to the four phases of swallowing. In our cohort, 13.5% of the 755 patients were diagnosed with swallowing difficulties. The outcome of the VFS-studies of 42 patients showed difficulties in the oral and pharyngeal phases with both thin and thick liquids. Patients with more severe mandibular hypoplasia showed more difficulties to form an appropriate bolus compared to patients who were less severely affected. This is the first study to document swallowing problems in patients with CFM. Difficulties were seen in both the oral and pharyngeal phases. We recommend routine screening for swallowing issues by a speech and language therapist in all patients with CFM and to obtain a VFS-study in patients with a type III mandible.Electronic supplementary materialThe online version of this article (doi:10.1007/s00455-017-9851-x) contains supplementary material, which is available to authorized users.

Multidisciplinary approach in a case of hemifacial microsomia: Speech and language pathologist contributions.

“…The present work points out the importance of the application of an early treatment program from the early stages of childhood, initially based on the two vital functions: feeding (swallowing difficulties) and breathing (Caron, Pluijimers, Joosten, Mathijssen, Schroeff, Dunaway and Koudstaal, 2015). Madi, Shetty, Babu and Achalli, 2014); (Van de Lande, Caron, Pluijmers, Joosten, Streppel, Dunaway, ... & Padwa, B. L. 2018); (Vila, Garmendía, Felipe, Suarez, Sánchez and Álvarez, 2010) as well as the need for a rigorous audiological follow-up of the baby to favor an adequate development of language, as well as the detection of difficulties in nasal permeability or a possible tubal dysfunction, which in short, allow the establishment of standardized respiratory and swallow patterns (Borras and Rosell, 2008) providing stability to the complex process of orofacial growth (Villanueva, 2014). On the other hand, further evidence is given for the importance of effective coordination between the maxillofacial surgeon, otorhinolaryngologist, orthodontist and the speech therapist in charge of the myofunctional work with the masticatory muscles.…”

Manejo multidisciplinario con terapia de electroestimulación en un paciente con síndrome de Goldenhar, trastorno de la deglución y falla para crecer

“…Por otro lado, se ha descrito que del 40-80% de los pacientes con microsomía hemifacial presentarán dificultades para la succión, la masticación y la deglución 8 . En 2017, van de Lande, et al 8 reportaron más dificultades para la formación del bolo alimenticio, y por lo tanto para la deglución, en los pacientes con hipoplasia mandibular grave.…”

“…Por otro lado, se ha descrito que del 40-80% de los pacientes con microsomía hemifacial presentarán dificultades para la succión, la masticación y la deglución 8 . En 2017, van de Lande, et al 8 reportaron más dificultades para la formación del bolo alimenticio, y por lo tanto para la deglución, en los pacientes con hipoplasia mandibular grave. En el presente reporte se describe un paciente con varios factores asociados con la alteración de la mecánica de la deglución: paladar hendido, macrostomía, hipoplasia mandibular y alteraciones en la función de los músculos de la masticación y la deglución.…”

“…2 A). Los terapeutas expertos en foniatría y lenguaje realizan la terapia de rehabilitación motora oral, centrándose en el apoyo a la nutrición y el desarrollo de habilidades de alimentación, así como en garantizar la deglución segura para la prevención de la neumonía por aspiración y la asfixia [7][8][9] . Dicha terapia se clasifica en movimientos activos, pasivos (TRO) y sensitivos (con o sin NMES).…”

Poly(ε-Caprolactone) Resorbable Auxetic Designed Knitted Scaffolds for Craniofacial Skeletal Muscle Regeneration

“…Craniofacial microsomia is a congenital deformity which affects approximately 1 in every 5600 children across the USA. It is characterized by improper growth of skull and face tissues on one or both sides of the face which creates a structural deficiency leading to clinical abnormalities like functional loss in hearing, swallowing, breathing and feeding, and hinders the child’s aesthetic development, such as facial expressions and appearance leading to social issues like acceptance [ 1 , 2 ]. The causes of the deformity are unknown, but it is thought to be the result of a genetic abnormality during embryo development [ 1 ].…”