Videofluoroscopic Swallowing Study Findings in Full-Term and Preterm Infants With Dysphagia

Abstract

ObjectiveTo determine the clinical characteristics and videofluoroscopic swallowing study (VFSS) findings in infants with suspected dysphagia and compare the clinical characteristics and VFSS findings between full-term and preterm infants.MethodsA total of 107 infants (67 full-term and 40 preterm) with suspected dysphagia who were referred for VFSS at a tertiary university hospital were enrolled in this retrospective study. Clinical characteristics and VFSS findings were reviewed by a physiatrist and an experienced speech-language pathologist. The association between the reasons of referral for VFSS and VFSS findings were analyzed.ResultsMean gestational age was 35.1±5.3 weeks, and mean birth weight was 2,381±1,026 g. The most common reason for VFSS referral was 'poor sucking' in full-term infants and 'desaturation' in preterm infants. The most common associated medical condition was 'congenital heart disease' in full-term infants and 'bronchopulmonary dysplasia' in preterm infants. Aspiration was observed in 42 infants (39.3%) and coughing was the only clinical predictor of aspiration in VFSS. However, 34 of 42 infants (81.0%) who showed aspiration exhibited silent aspiration during VFSS. There were no significant differences in the VFSS findings between the full-term and preterm infants except for 'decreased sustained sucking.'ConclusionThere are some differences in the clinical manifestations and VFSS findings between full-term and preterm infants with suspected dysphagia. The present findings provide a better understanding of these differences and can help clarify the different pathophysiologic mechanisms of dysphagia in infants.

Oropharyngeal Dysphagia in Children

“…This can make breastfeeding difficult and accounts for more desaturations in preterm infants when feeding. 24 Preterm infants are also more likely to suffer anoxia or hypoxia at birth. This can result in permanent, but sometimes subtle, neurologic damage, including dysfunctional feeding patterns.…”

“…24 A sucking pattern consists of suckling bursts. An immature pattern may include a short burst of 4 to 6 sucks at 1 to 1.5 sucks/s and a mature pattern may consist of approximately 30 sucks at 2 sucks/s.…”

Interdisciplinary Care of Children with Severe Bronchopulmonary Dysplasia

“…Common sources of aspiration may include oral intake via dysfunctional swallowing, 71 gastroesophageal reflux, 72 a patient’s own oral secretions, and potentially increased upper respiratory secretions during infections. Limited recurrent aspiration may result in chronic respiratory symptoms, such as coughing, wheezing, or tachypnea (although aspiration in preterm infants can frequently be “silent”); 73 desaturations or hypercarbia; 74 or poor weight gain. More acute episodes of aspiration may result in pneumonia, tracheitis, or bronchitis, often accompanied by an escalation of respiratory support.…”

Infant Videofluoroscopic Swallow Study Testing, Swallowing Interventions, and Future Acute Respiratory Illness

“…Videofluoroscopic swallow study (VFSS) is the gold-standard radiographic test for evaluating swallowing, 9 and VFSS abnormalities are common among infants clinically thought to have difficulty swallowing. [10][11][12][13] Which infant characteristics predict VFSS abnormalities and whether interventions designed to protect the airway are efficacious remain unclear. An observational study in infants with neurologic impairment did not find a decrease in respiratory admissions after fundoplication.…”