TY - JOUR
T1 - Objective assessment of swallow function in children with suspected aspiration using pharyngeal automated impedance manometry
AU - Rommel, Nathalie
AU - Selleslagh, M
AU - Hoffman, Ilse
AU - Smet, Maria
AU - Davidson, Geoffrey
AU - Tack, J
AU - Omari, Taher
PY - 2014/6
Y1 - 2014/6
N2 - OBJECTIVES:: The purpose of the present study was to apply a new method, pharyngeal automated impedance manometry (AIM), as an objective assessment tool of swallow function relevant to aspiration, in a cohort of paediatric patients with dysphagia. METHODS:: We studied 20 children (mean age 6 years [5 months to 13.4 years]) referred for videofluoroscopy to assess aspiration risk with simultaneous manometry-impedance. Fluoroscopic evidence of aspiration was scored using a validated aspiration-penetration score. Pressure-flow profiles were analysed using AIM analysis measuring peak pressure, pressure at nadir impedance, time from nadir impedance to peak pressure, and flow interval. These variables were combined into a swallow risk index (SRI). RESULTS:: Six of 20 children presented with deglutitive aspiration during videofluoroscopic assessment of swallowing. Of 58 liquid swallows analysed, in 9 aspiration was observed. Multiple logistic regression identified longer flow interval (P<0.05), higher SRI (P<0.05) and increased pressure in the upper oesophageal sphincter during maximal bolus flow (P<0.05) to be the dominant risk variables predictive of aspiration in children. Each of these nonradiologically derived pressure-flow variables correlated with higher aspiration scores on videofluoroscopy (P<0.01). CONCLUSIONS:: We present novel, preliminary findings in children with deglutitive aspiration, suggesting that pharyngeal AIM can detect alterations in pressure-flow characteristics of swallowing that predispose to aspiration risk.
AB - OBJECTIVES:: The purpose of the present study was to apply a new method, pharyngeal automated impedance manometry (AIM), as an objective assessment tool of swallow function relevant to aspiration, in a cohort of paediatric patients with dysphagia. METHODS:: We studied 20 children (mean age 6 years [5 months to 13.4 years]) referred for videofluoroscopy to assess aspiration risk with simultaneous manometry-impedance. Fluoroscopic evidence of aspiration was scored using a validated aspiration-penetration score. Pressure-flow profiles were analysed using AIM analysis measuring peak pressure, pressure at nadir impedance, time from nadir impedance to peak pressure, and flow interval. These variables were combined into a swallow risk index (SRI). RESULTS:: Six of 20 children presented with deglutitive aspiration during videofluoroscopic assessment of swallowing. Of 58 liquid swallows analysed, in 9 aspiration was observed. Multiple logistic regression identified longer flow interval (P<0.05), higher SRI (P<0.05) and increased pressure in the upper oesophageal sphincter during maximal bolus flow (P<0.05) to be the dominant risk variables predictive of aspiration in children. Each of these nonradiologically derived pressure-flow variables correlated with higher aspiration scores on videofluoroscopy (P<0.01). CONCLUSIONS:: We present novel, preliminary findings in children with deglutitive aspiration, suggesting that pharyngeal AIM can detect alterations in pressure-flow characteristics of swallowing that predispose to aspiration risk.
KW - Deglutition disorders
KW - Diagnosis
KW - Electric impedance
KW - Manometry
KW - Respiratory aspiration
UR - http://www.scopus.com/inward/record.url?scp=84901595728&partnerID=8YFLogxK
U2 - 10.1097/MPG.0000000000000337
DO - 10.1097/MPG.0000000000000337
M3 - Article
SN - 0277-2116
VL - 58
SP - 789
EP - 794
JO - Journal of Pediatric Gastroenterology and Nutrition
JF - Journal of Pediatric Gastroenterology and Nutrition
IS - 6
ER -