Swallowing problems in children with a tracheostomy tube

Streppel, M.T.; Veder, L.L.; Pullens, Bas; Joosten, Koen

doi:10.1016/j.ijporl.2019.05.003

Cited by 22 publications

(17 citation statements)

References 42 publications

(61 reference statements)

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“…The latter are likely confounding factors leading to poor neurocognition. But having a tracheostomy may be an additional risk factor for greater speech and language delays despite specific therapies and further reduced communication options [25]. In this context, our results may suggest that mask ventilation should be preferred whenever possible in terms of safety, because the integrity of the oral-tracheal sphere may favour the subsequent development of speech and language.…”

Section: Discussionmentioning

confidence: 84%

Neurocognition in Congenital Central Hypoventilation Syndrome: influence of genotype and ventilation method

Trang

Bourgeois

Chéliout-Héraut

2020

Orphanet J Rare Dis

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Background Congenital Central Hypoventilation Syndrome (CCHS) is characterized by central hypoventilation due to abnormal autonomic control of breathing and global dysautonomia. Patients harbour heterozygous PHOX-2B gene mutations which are polyalanine repeats of various lengths in most of the cases. A few previous studies have reported learning difficulties and neuropsychological disorders in patients with CCHS. The aims of the present study were (1) to explore the intellectual abilities of a group of children with CCHS followed up in the centre of reference for CCHS in France using the Wechsler batteries of tests, (2) and to assess whether there was any association between CCHS characteristics and various domains of the intellectual functioning. Results There were 34 consecutive patients (15 males, 19 females) of mean (SD) age of 7.8 (3.8) years, ranging from 4 to 16 years and 6 months. Mean score of full-scale intelligence quotient was 82 (20), being in the low average range. Indexes of working memory and processing speed were significantly lower as compared to the other Wechsler indexes. There were two important findings: (1) full-scale intelligence quotient as well as indexes of verbal comprehension and processing speed were significantly greater in patients with mask ventilation than in those with tracheostomy ventilation (p = 0.012, 0.032 and 0.042 respectively); (2) most interestingly, in the patients with polyalanine repeats mutations, all intellectual indexes negatively correlated with the number of polyalanine expansion, with statistical significance reached for indexes of fluid reasoning and working memory (R = − 0.449, p = 0.032 and R = − 0.562, p = 0.012 respectively). Conclusions CCHS increased the risk to develop neurocognitive deficiencies, affecting particularly speed of processing and working memory. Our results suggested that both genetics and ventilation method could be also involved in the physiopathology of neurocognitive impairment. Further investigations were required to untangle the complex underlying processes. Neurocognitive assessments should be performed regularly in children with CCHS in order to plan re-education programs, adapt school integration and improve quality of life.

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Section: Discussionmentioning

confidence: 84%

Neurocognition in Congenital Central Hypoventilation Syndrome: influence of genotype and ventilation method

Trang

Bourgeois

Chéliout-Héraut

2020

Orphanet J Rare Dis

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“…Besides pre-existing swallowing difficulties and MDO itself, the presence of a tracheostomy tube can affect the swallowing mechanism as well. A study by Streppel et al reported that 70% of the tracheostomized children had problems in at least one of the four stages of swallowing 25 . It is believed that the tube tethers and desensitizes the larynx, resulting in a decreased subglottic airway pressure.…”

Section: Discussionmentioning

confidence: 99%

Feeding and swallowing outcomes following mandibular distraction osteogenesis: an analysis of 22 non-isolated paediatric cases

Plas

Streppel

Pullens

et al. 2022

International Journal of Oral and Maxillofacial Surgery

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“…In research 33 with 31 TT children, 19 aspirated food material, and the authors considered that most of the children had swallowing problems in the various swallowing phases and were at greater risk of aspiration. In the present study, an increased number of patients with oral feeding at hospital discharge -32 (62.8%) children had oral feeding, 19 (37.3%) of whom with full oral feeding, was verified.…”

Section: Discussionmentioning

confidence: 99%

Feeding of children with tracheostomy at hospital discharge

et al. 2021

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Purpose: to describe the work of speech-language-hearing therapists and verify which was the most prevalent feeding method in the sample studied. Methods: a descriptive observational study based on data surveyed from medical records. The following variables were used: age, medical diagnosis, hospital ward, feeding method before and after the tracheostomy, time of speech-language-hearing care, and speech-language-hearing discharge. The data were submitted to descriptive statistical analysis with the appropriate tests to compare the categorical variables. All infants and children with tracheostomy performed either before or during hospital stay between July 2017 and July 2018, who received speech-language-hearing care upon request of the physician, were included. Results: a total of 51 children took part in the study, most of whom were males (56.9%), with a median age of 12 months, ranging from 1 month to 12 years old at the time of the speech-language-hearing assessment. The feeding methods at hospital discharge were described as follows: full oral feeding (37%), partial oral feeding (25.5%), nasogastric/nasoenteral tube (19.6%), and gastrostomy (17.6%). Conclusion: the full oral diet of tracheostomized children was the most prevalent feeding method at hospital speech-language-hearing discharge.

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Swallowing problems in children with a tracheostomy tube

Cited by 22 publications

References 42 publications

Neurocognition in Congenital Central Hypoventilation Syndrome: influence of genotype and ventilation method

Neurocognition in Congenital Central Hypoventilation Syndrome: influence of genotype and ventilation method

Feeding and swallowing outcomes following mandibular distraction osteogenesis: an analysis of 22 non-isolated paediatric cases

Feeding of children with tracheostomy at hospital discharge

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