Neonatal swallowing assessment using fiberoptic endoscopic evaluation of swallowing (FEES)

Vetter-Laracy, Susanne; Osona, Borja; Roca, Antonia; Peña-Zarza, Jose Antonio; Gil, José A.; Figuerola, Joan

doi:10.1002/ppul.23946

Cited by 23 publications

(36 citation statements)

References 26 publications

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“…Literature shows that penetration is linked to tracheal aspiration ( 22 ). Our pilot data showed that FEES detected more penetration than VFSS, which corroborates with available evidence reported in both the pediatric ( 4 , 23 – 25 ) and adult literature ( 20 , 26 , 27 ). This supports the notion that FEES is more sensitive than VFSS in detecting penetration.…”

Section: Discussionsupporting

confidence: 91%

Simultaneous Videofluoroscopy and Endoscopy for Dysphagia Evaluation in Preterm Infants—A Pilot Study

et al. 2020

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Section: Discussionsupporting

confidence: 91%

Simultaneous Videofluoroscopy and Endoscopy for Dysphagia Evaluation in Preterm Infants—A Pilot Study

et al. 2020

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“…In contrast to patients without known dysphagia, the goal for patients with previously diagnosed pharyngeal dysphagia may be to trial a specific consistency with the hope of either adjusting the diet, or reassessing safety in the setting of fluctuating clinical symptoms . Under these circumstances, an abnormal SEES may allow one to avoid a repeat VFSS even if FEES is unsuccessful, as a known abnormality on VFSS will be predictably present in nearly 90% of patients based on our results.…”

Section: Discussionmentioning

confidence: 88%

“…These findings have several implications worthy of discussion. In a child who is otherwise naive to instrumental swallow studies and without an established diagnosis of swallow dysfunction, one may wonder if a VFSS is necessary to perform following an abnormal FEES, as it may not provide additional insight . However, if a SEES is performed and is abnormal, VFSS may be more assertively avoided, as swallow abnormalities are likely to exist based on the positive predictive value of the static evaluation.…”

Section: Discussionmentioning

confidence: 99%

Static endoscopic swallow evaluation in children

et al. 2019

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Objectives: Static Endoscopic Evaluation of Swallowing (SEES) has been demonstrated to have a strong correlation with the Videofluoroscopic Swallow Study (VFSS) in adults. In children, Fiberoptic Endoscopic Evaluations of Swallow (FEES) are frequently performed to avoid repeated VFSS; however, a subset of the population does not tolerate FEES. The purpose of this study was to evaluate the utility of a modified SEES in children.Methods: Charts of 50 consecutive patients who underwent FEES evaluations were reviewed. Patients age 3 months to 12 years undergoing SEES, FEES, and VFSS were extracted. We compared a binary assessment of outcome on SEES versus VFSS as the diagnostic standard to report characteristics, including sensitivity, specificity, and positive and negative predicted value.Results: A total of 36 patients met all inclusion criteria (mean age 2.8 years). Using the VFSS as the diagnostic standard, residue seen on SEES had a sensitivity of 80.0%, specificity of 85.7%, a positive predictive value of 88.9%, and a negative predictive value of 75.0% for predicting deep penetration or aspiration.Conclusion: SEES may be helpful for developing an initial diagnostic impression and may serve as a platform for patient and caregiver counseling. In children who are unable to cooperate with FEES, SEES may provide clinical insight in predicting an abnormal swallow study; however, a normal SEES was less reliable in predicting a safe swallow on subsequent VFSS in this patient population.

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“…Rates of oral aspiration and penetration are elevated in premature infants, and an abnormal VFSS tended to be commoner among premature infants in our study, although the difference was not statistically significant. 23 The relatively high rates of prematurity in our population may have increased the prevalence of abnormal VFSS, but would not be expected to affect rates of the laryngeal cleft. In Duncan et al 13 series of 137 infants with isolated laryngeal penetration, 35% were premature.…”

Section: Genetic Causes Of Laryngeal Cleft Include 22q Deletion Syndrmentioning

confidence: 81%

Oral aspiration, type 1 laryngeal cleft, and respiratory tract infections in canadian inuit children

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Agarwal

Saban

et al. 2019

Pediatric Pulmonology

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Canadian Inuit infants suffer the highest rate of lower respiratory tract infections (LRTI's) in the world. The causes of this are incompletely understood. The primary objective of this study was to determine whether there exists an association between respiratory morbidity and oral aspiration in Inuit children. A retrospective chart review was conducted including children from Nunavut who underwent Video Fluoroscopic Swallowing Study between the years of 2001 to 2015. The primary outcome was hospitalization for LRTI. We hypothesized that infants found to have aspiration would experience a higher rate of admissions for LRTI than those with normal swallowing studies. One‐hundred and twenty‐seven patients were identified, of whom 94 were included. Fifty‐six percent of patients had an abnormal swallowing study. Compared with patients with normal swallowing, the incidence rate of LRTI was higher in patients with aspiration (incidence rate ratio [IRR] = 1.51; 95% confidence interval [CI] = 1.23‐1.87) and in patients with penetration (IRR = 1.40; 95% CI = 1.11‐1.76). Fourteen percent of patients had confirmed laryngeal cleft; patients with confirmed presence of this also had a higher incidence rate of LRTI (IRR = 1.66; 95% CI = 1.32‐2.07). The incidence of abnormal swallowing study showed an 11‐fold variation across the five regions in Nunavut, with the highest prevalence in west Qikiqtani Region (Baffin Island). We conclude that swallowing dysfunction is not only prevalent amongst Canadian Inuit but clinically significant. This is the first study to demonstrate an association between swallowing dysfunction and respiratory morbidity in this population. Geographic distribution patterns and high rates of laryngeal cleft may point to a potential genetic etiology for what remains at this point, idiopathic swallowing dysfunction.

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Neonatal swallowing assessment using fiberoptic endoscopic evaluation of swallowing (FEES)

Abstract: Aspiration is very frequent in premature infants who present desaturations during feeding and FEES is a useful method for diagnosing and suggesting treatments.

Cited by 23 publications

References 26 publications

Simultaneous Videofluoroscopy and Endoscopy for Dysphagia Evaluation in Preterm Infants—A Pilot Study

Simultaneous Videofluoroscopy and Endoscopy for Dysphagia Evaluation in Preterm Infants—A Pilot Study

Static endoscopic swallow evaluation in children

Oral aspiration, type 1 laryngeal cleft, and respiratory tract infections in canadian inuit children

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