Evaluation of Swallowing Function in Patients With H-type Tracheoesophageal Fistula

IF 2.4 2区 医学 Q1 PEDIATRICS
Mehmet Furkan Yalabık , Selen Serel Arslan , Özlem Boybeyi , Numan Demir , Tutku Soyer
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Abstract

Aim

Although esophageal atresia (EA) patients can present with dysphagia, the swallowing function of patients with H-type tracheoesophageal fistula (H-TEF) has not been systematically assessed. Therefore, a retrospective study was carried out to evaluate the swallowing function of patients with H-TEF.

Methods

Children operated for H-TEF with videofluoroscopic swallowing evaluation (VFSE) were included. Penetration-aspiration score, oral phase efficacy, delay in swallowing reflex, velopharyngeal closure, and esophageal dysmotility during liquid and solid food swallowing were assessed by using VFSE recordings. Penetration-aspiration score <6 was considered as ‘no aspiration’, whereas scores ≥6 was assessed as ‘aspiration’. Oral phase efficacy, delay in swallowing reflex and esophageal dysmotility were scored as 0 (normal) to 3 (severe problem), and delay in swallowing reflex was ranged from 0 (no delay) to 3 (severe delayed, >5 s).

Results

Among eleven patients, ten patients who met the inclusion criteria were included. The mean age of the patients was 3.4 years (min = 1, max = 9). Two (20 %) patients had aspiration in liquids and none of them had in solids. One patient had minimum and the other one had mild problem in oral phase efficacy (n = 2, 20 %). Delay in swallowing reflex and velopharyngeal closure were normal in all patients. In five of the patients (50 %), there was mild (n = 1) to severe (n = 4) esophageal dysmotility.

Conclusion

Children with H-TEF had modest swallowing impairment in all phases. Although, it is not as severe as in EA patients, evaluation of the swallowing function should be part of the clinical practice of patients with H-TEF.
h型气管食管瘘患者吞咽功能的评价
目的虽然食管闭锁(EA)患者可出现吞咽困难,但h型气管食管瘘(H-TEF)患者的吞咽功能尚未得到系统评估。因此,我们对H-TEF患者的吞咽功能进行了回顾性研究。方法对行H-TEF的儿童进行透视吞咽评估(VFSE)。通过VFSE记录评估渗透-吸入评分、口服期疗效、吞咽反射延迟、腭咽闭合和吞咽液体和固体食物时的食管运动障碍。穿透-误吸得分<;6被认为是“无误吸”,而得分≥6被评估为“误吸”。口服期疗效、吞咽反射延迟和食管运动障碍评分为0(正常)至3(严重问题),吞咽反射延迟评分为0(无延迟)至3(严重延迟,5秒)。结果11例患者中有10例符合纳入标准。患者平均年龄3.4岁(最小= 1岁,最大= 9岁),2例(20%)患者有液体误吸,无固体误吸。1例患者口服期疗效最低,1例患者有轻度问题(n = 2, 20%)。所有患者的吞咽反射延迟和腭咽闭合均属正常。5例(50%)患者有轻度(n = 1)至重度(n = 4)食管运动障碍。结论H-TEF患儿各期均有中度吞咽障碍。虽然不像EA患者那么严重,但吞咽功能的评估应该是H-TEF患者临床实践的一部分。
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来源期刊
CiteScore
1.10
自引率
12.50%
发文量
569
审稿时长
38 days
期刊介绍: The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.
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