The evaluation of deglutition with videofluoroscopy after repair of esophageal atresia and/or tracheoesophageal fistula

Demir, Numan; Serel, Selen; Soyer, Tutku; Tanyel, Feridun Cahit

doi:10.1016/j.jpedsurg.2015.07.002

Cited by 30 publications

(30 citation statements)

References 12 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Abnormalities in different phases require different treatment approaches [1, 8]. The extent to which dysphagia occurs in the oropharyngeal swallowing phase remains unclear [9, 26]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Dysphagia in children with repaired oesophageal atresia

et al. 2016

View full text Add to dashboard Cite

Dysphagia is a common problem in children with repaired oesophageal atresia (OA). Abnormalities in the oropharyngeal and oesophageal phase have hardly been studied. The aims of this study were to assess the prevalence of dysphagia in children with repaired OA and to identify and differentiate oral and pharyngeal dysphagia based on videofluoroscopic swallow study (VFSS) findings in a limited number of children in this cohort. Medical records of 111 patients, born between January 1996 and July 2013 and treated at the Radboudumc Amalia Children’s Hospital, were retrospectively reviewed. The prevalence of dysphagia was determined by the objective and modified Functional Oral Intake Scale (FOIS) in four age groups. The first performed VFSS of 12 children was structurally assessed. The prevalence of dysphagia was 61 of 111 patients (55 %) in age group <1 year. In age group 1–4, 5–11 and 12–18 years, the prevalence of dysphagia decreased from 54 of 106 (51 %) patients to 11 of 64 (17 %) and 5 of 24 (21 %) patients. The 12 VFSS’s reviews revealed oral dysphagia in 36 % and pharyngeal dysphagia in 75 %.Conclusions: This study highlights dysphagia as an important problem in different age groups of children with repaired OA. Furthermore, our study shows the presence of oropharyngeal dysphagia in this population. This study emphasizes the need to standardize the use of objective dysphagia scales, like the modified FOIS, to provide a careful follow-up of children with repaired OA. What is Known: • Prevalence of dysphagia in children with repaired oesophageal atresia varies widely (ranges from 45 to 70 %) in literature. • Oral, pharyngeal and oesophageal dysphagia require different treatment approaches. What is New: • We determined dysphagia based on functional oral intake and provide an overview of change in dysphagia prevalence and severity over time in children with repaired OA. • Our study shows that dysphagia, including oropharyngeal dysphagia, is highly prevalent in young children with repaired OA and improves with time.

show abstract

“…Abnormalities in different phases require different treatment approaches [1, 8]. The extent to which dysphagia occurs in the oropharyngeal swallowing phase remains unclear [9, 26]. …”

Section: Introductionmentioning

confidence: 99%

“…The videofluoroscopic swallow study (VFSS) is generally accepted as the best investigation to objectively assess the oropharyngeal phase of the swallow function [1, 8]. So far, occurrence of dysphagia in the oropharyngeal phase of the swallow has hardly been studied in children with repaired OA [9, 26]. …”

Section: Introductionmentioning

confidence: 99%

Dysphagia in children with repaired oesophageal atresia

et al. 2016

View full text Add to dashboard Cite

show abstract

“…In order to evaluate the effects of NF on deglutitive functions, preoperative and postoperative swallowing functions of children were investigated by VFS. In addition to VFS findings, penetration aspiration (PAS) and functional oral intake scales (FOIS) were compared before and after antireflux surgery 4 .…”

mentioning

confidence: 99%

“…Oral, pharyngeal and esophageal phases of deglutition are evaluated with different consistencies of food in this procedure 4 . We performed liquid (1-3-5-10-20 ml of barium), pudding (3-5-10 ml of barium with pudding) and solid (5-10 ml of barium with biscuit) barium tests, and used the 5 ml volume results for the analysis, since this amount provides more effective evaluation of swallowing physiology.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Does Nissen fundoplication improve deglutition in children?

Soyer¹,

Demir²,

Karhan³

et al. 2017

Turk J Pediatr

Self Cite

View full text Add to dashboard Cite

A prospective study was performed to evaluate the effect of Nissen fundoplication (NF) on deglutition in children. Children who underwent NF between 2011-2015 were evaluated for demographic features, clinical findings, diagnostic methods for gastroesophageal reflux (GER) and indications for NF. Penetration aspiration scale (PAS), functional oral intake scale (FOIS) and esophageal functions were evaluated by videoflouroscopy (VFS). Preoperative and postoperative VFS findings were compared to evaluate the effect of NF on clinical findings and deglutition. Twenty-three children with a mean age of 5.08 ± 3.7 years were included. Female to male ratio was 15:8. Recurrent respiratory infections (RTI) (n: 14, 60.8%), swallowing dysfunction (n:13, 56.5%) and vomiting (n:10, 43.4%) were the most common symptoms. Preoperatively GER was diagnosed with barium swallowing study (BSS) contrast graphs (n:20, 87%) and with 24-hour esophageal pH monitorization (n:8, 34.8%). In 39.1% of patients, medical treatment for GER was used with a mean duration of 8 ± 5.8 months. Indications for NF were swallowing dysfunction (n: 18, 78%), GER complications (n:6, 26%), associated anatomical problems (n:4, 17.3%) and unresponsiveness to medical treatment (n: 3, 13%). Postoperative barium swallowing study and 24-hour esophageal pH monitorization showed no GER after NF in 95% of patients. Number of RTI were significantly decreased after NF (preoperative vs postoperative infection rate 4.21 vs 1.6 respectively, p<0.05). VFS findings showed that PAS was significantly decreased after NF during both liquid and semi-liquid swallowing (p<0.05). After NF, upper esophageal opening (UEO) was decreased when compared to preoperative VFS findings (p<0.05 Esophageal cleaning, esophageal motility, esophageal backflow and lower esophageal sphincter narrowing did not alter after NF (p>0.05). FOIS were significantly improved after NF (p<0.05). VFS findings showed that penetration and aspiration were significantly decreased after NF and children had less RTI. Although, esophageal motility evaluated by VFS did not changed after NF, functional oral intake significantly improved in children.

show abstract

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Koumbourlis

Belessis

Cataletto

et al. 2020

Pediatric Pulmonology

View full text Add to dashboard Cite

Tracheoesophageal fistula (TEF) with esophageal atresia (EA) is a common congenital anomaly that is associated with significant respiratory morbidity throughout life. The objective of this document is to provide a framework for the diagnosis and management of the respiratory complications that are associated with the condition. As there are no randomized controlled studies on the subject, a group of experts used a modification of the Rand Appropriateness Method to describe the various aspects of the condition in terms of their relative importance, and to rate the available diagnostic methods and therapeutic interventions on the basis of their appropriateness and necessity. Specific recommendations were formulated and reported as Level A, B, and C based on whether they were based on “strong”, “moderate” or “weak” agreement. The tracheomalacia that exists in the site of the fistula was considered the main abnormality that predisposes to all other respiratory complications due to airway collapse and impaired clearance of secretions. Aspiration due to impaired airway protection reflexes is the main underlying contributing mechanism. Flexible bronchoscopy is the main diagnostic modality, aided by imaging modalities, especially CT scans of the chest. Noninvasive positive airway pressure support, surgical techniques such as tracheopexy and rarely tracheostomy are required for the management of severe tracheomalacia. Regular long‐term follow‐up by a multidisciplinary team was considered imperative. Specific templates outlining the elements of the clinical respiratory evaluation according to the patients’ age were also developed.

show abstract

The evaluation of deglutition with videofluoroscopy after repair of esophageal atresia and/or tracheoesophageal fistula

Cited by 30 publications

References 12 publications

Dysphagia in children with repaired oesophageal atresia

Dysphagia in children with repaired oesophageal atresia

Does Nissen fundoplication improve deglutition in children?

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Contact Info

Product

Resources

About