Dynamic Imaging Grade of Swallowing Toxicity in Children with Esophageal Atresia.

IF 1.5 3区医学 Q2 PEDIATRICS

European Journal of Pediatric Surgery Pub Date : 2024-10-01 Epub Date: 2023-09-25 DOI:10.1055/a-2181-2293

Numan Demir, Begüm Pişiren, Selen Serel Arslan, Ozlem Boybeyı-Turer, Tutku Soyer

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引用次数: 0

Abstract

Introduction: The Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scale was developed to evaluate the safety, efficiency, and overall pharyngeal swallowing performance in patients with dysphagia (DIGESTs, DIGESTe, and DIGESTt, respectively). Although various types of swallowing dysfunction are encountered in children with esophageal atresia (EA), oropharyngeal dysphagia poses risk for aspiration. Therefore, a retrospective study was performed to evaluate the safety and efficacy of swallowing by using DIGEST score in children with EA.

Patients and methods: Thirty-nine EA patients were included. The demographic features, respiratory problems, results, and outcomes of surgical treatment were evaluated from medical records. The videofluoroscopic swallowing evaluation investigated for both airway protection and bolus residuals at the level of vallecula, posterior pharyngeal wall, and pyriform sinus at liquid and pudding consistencies. The penetration and aspiration scale (PAS) was used to define penetration and aspiration severity, and DIGEST was used to evaluate DIGESTs, DIGESTe, and DIGESTt.

Results: The median age of the patients were 13 months (7-39 months), and male-to-female ratio was 25:14. Sixty-seven percent of patients were type-C EA and 61% of them has associated anomalies; 38% of patients had aspiration (PAS = 6-8) in liquids and 10% in pudding consistency. Life-threatening/profound swallowing dysfunction in DIGESTe (DIGEST = 4) was seen in 13% (n = 5) of patients; 40% of EA patients showed severe problems in DIGESTt.

Conclusion: DIGEST is a valid and reliable tool to define the efficacy and safety of swallowing in children with EA.

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儿童食管闭锁吞咽毒性（消化）的动态影像学分级。

引言：吞咽毒性动态影像分级量表（DIGEST）用于评估吞咽困难患者的安全性、有效性和咽下综合表现。尽管食道闭锁（EA）的儿童会遇到各种类型的吞咽功能障碍，但口咽吞咽困难会带来误吸的风险。因此，我们进行了一项回顾性研究，用DIGEST评分评估EA儿童吞咽的安全性和有效性。方法：纳入39例EA患者。根据医疗记录评估人口统计学特征、呼吸系统问题、手术治疗的结果和结果。吞咽的视频荧光镜评估（VFSE）研究了在液体和布丁稠度下，valcula、咽后壁和梨状窦水平的气道保护和团块残留。穿刺和抽吸量表（PAS）用于确定穿刺和抽吸的严重程度，DIGEST用于评估安全性（DIGEST）、有效性（DIGESTe）和咽下综合功能（DIGESTt）。结果：患者的中位年龄为13个月（7-39个月），男女比例为25:14。67%的患者为C型EA，61%的患者有相关异常。38%的患者在液体中有抽吸（PAS=6-8），10%的患者在布丁稠度中有抽吸。13%（n=5）的患者出现危及生命/严重吞咽功能障碍（DIGEST=4）。40%的EA患者在DIGEST中表现出严重的问题。结论：DIGEST是确定EA儿童吞咽有效性和安全性的有效和可靠的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pediatric Surgery 医学-外科

CiteScore

3.90

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.