Role of fiberoptic endoscopic evaluation of swallowing (FEES) in children with suspected dysphagia

IF 2.8 4区 医学 Q1 PEDIATRICS
{"title":"Role of fiberoptic endoscopic evaluation of swallowing (FEES) in children with suspected dysphagia","authors":"","doi":"10.1016/j.jped.2024.03.008","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To assess FEES findings in defining oral feeding safety in children with suspected dysphagia, comparing them with clinical feeding evaluation results.</p></div><div><h3>Methods</h3><p>This study comprised a case series involving children with suspected dysphagia, referred for evaluation by otolaryngologists and speech-language pathologists (SLPs) at a Brazilian quaternary public university hospital. These children underwent both clinical evaluations and fiberoptic endoscopic evaluation of swallowing (FEES), with a comprehensive collection of demographic and clinical data. Subsequently, the authors performed a comparative analysis of findings from both assessments.</p></div><div><h3>Results</h3><p>Most patients successfully completed the FEES procedure (93.7%), resulting in a final number of 60 cases included in the study. The prevalence of dysphagia was confirmed in a significant 88% of these cases. Suspected aspiration on clinical SLP evaluation was present in 34 patients. Of these, FEES confirmed aspiration or penetration in 28 patients. Among the 35 patients with aspiration or penetration on FEES, 7 (20%) had no suspicion on SLP clinical assessment. All seven patients in whom clinical SLP evaluation failed to predict penetration/aspiration had neurological disorders. The median age of the children was 2.8 years, and 49 (81.6%) had neurological disorders, while 35 (58.3%) had chronic pulmonary disease. The most prevalent complaints were choking (41.6%) and sialorrhea (23.3%).</p></div><div><h3>Conclusion</h3><p>FEES can diagnose structural anomalies of the upper aerodigestive tract and significantly contribute to the detection of aspiration and penetration in this group of patients with suspected dysphagia, identifying moderate and severe dysphagia even in cases where clinical assessment had no suspicion.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S002175572400041X/pdfft?md5=ac24dfa2ef0332bbdc6b597b764c5010&pid=1-s2.0-S002175572400041X-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Jornal de pediatria","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S002175572400041X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0

Abstract

Objective

To assess FEES findings in defining oral feeding safety in children with suspected dysphagia, comparing them with clinical feeding evaluation results.

Methods

This study comprised a case series involving children with suspected dysphagia, referred for evaluation by otolaryngologists and speech-language pathologists (SLPs) at a Brazilian quaternary public university hospital. These children underwent both clinical evaluations and fiberoptic endoscopic evaluation of swallowing (FEES), with a comprehensive collection of demographic and clinical data. Subsequently, the authors performed a comparative analysis of findings from both assessments.

Results

Most patients successfully completed the FEES procedure (93.7%), resulting in a final number of 60 cases included in the study. The prevalence of dysphagia was confirmed in a significant 88% of these cases. Suspected aspiration on clinical SLP evaluation was present in 34 patients. Of these, FEES confirmed aspiration or penetration in 28 patients. Among the 35 patients with aspiration or penetration on FEES, 7 (20%) had no suspicion on SLP clinical assessment. All seven patients in whom clinical SLP evaluation failed to predict penetration/aspiration had neurological disorders. The median age of the children was 2.8 years, and 49 (81.6%) had neurological disorders, while 35 (58.3%) had chronic pulmonary disease. The most prevalent complaints were choking (41.6%) and sialorrhea (23.3%).

Conclusion

FEES can diagnose structural anomalies of the upper aerodigestive tract and significantly contribute to the detection of aspiration and penetration in this group of patients with suspected dysphagia, identifying moderate and severe dysphagia even in cases where clinical assessment had no suspicion.

纤维内窥镜吞咽评估 (FEES) 在疑似吞咽困难儿童中的作用。
目的评估 FEES 在确定疑似吞咽困难儿童口腔喂养安全性方面的发现,并将其与临床喂养评估结果进行比较:本研究包括一个病例系列,涉及巴西一家四级公立大学医院的耳鼻喉科医生和言语病理学家(SLP)转诊评估的疑似吞咽困难儿童。这些儿童接受了临床评估和纤维内窥镜吞咽评估(FEES),并全面收集了人口统计学和临床数据。随后,作者对这两项评估的结果进行了对比分析:大多数患者成功完成了 FEES 程序(93.7%),最终有 60 例患者纳入研究。在这些病例中,有 88% 的患者被确诊为吞咽困难。34 名患者在临床 SLP 评估中怀疑有误吸现象。其中,28 名患者的 FEES 证实了吸入或穿透。在 35 例经 FEES 诊断为吸入或穿透的患者中,有 7 例(20%)在 SLP 临床评估中未发现疑似吸入。临床 SLP 评估未能预测穿入/吸入的 7 名患者均患有神经系统疾病。患儿的中位年龄为 2.8 岁,49 人(81.6%)患有神经系统疾病,35 人(58.3%)患有慢性肺部疾病。最常见的主诉是窒息(41.6%)和鼻出血(23.3%):结论:FEES 可诊断上消化道结构异常,对检测这部分疑似吞咽困难患者的吸入和穿刺有很大帮助,即使在临床评估没有怀疑的情况下,也能检测出中度和重度吞咽困难。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Jornal de pediatria
Jornal de pediatria 医学-小儿科
CiteScore
5.60
自引率
3.00%
发文量
93
审稿时长
43 days
期刊介绍: Jornal de Pediatria is a bimonthly publication of the Brazilian Society of Pediatrics (Sociedade Brasileira de Pediatria, SBP). It has been published without interruption since 1934. Jornal de Pediatria publishes original articles and review articles covering various areas in the field of pediatrics. By publishing relevant scientific contributions, Jornal de Pediatria aims at improving the standards of pediatrics and of the healthcare provided for children and adolescents in general, as well to foster debate about health.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信