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Objective assessment of swallow function in children with suspected aspiration using pharyngeal automated impedance

Nathalie Rommel1, Margot Selleslagh, Ilse Hoffman

  • 1*Neurosciences, ExpORL, Faculty of Medicine †Translational Research Centre for Gastrointestinal Disease (TARGID), KU Leuven, Leuven, Belgium ‡Faculty of Health Sciences, Flinders University School of Medicine, Bedford Park, Australia §Pediatric Gastroenterology, Hepatology, and Nutrition ||Radiology, University Hospital Leuven, Leuven, Belgium ¶School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia.

Journal of Pediatric Gastroenterology and Nutrition
|February 21, 2014
PubMed

Insights

Pharyngeal automated impedance manometry (AIM) shows promise in objectively assessing pediatric dysphagia and aspiration risk. This new method identifies pressure-flow changes linked to swallowing difficulties in children.

Area of Science:

  • Pediatric Gastroenterology
  • Swallowing Disorders
  • Diagnostic Technologies

Background:

  • Pediatric dysphagia poses significant health risks, including aspiration.
  • Objective assessment of swallow function is crucial for effective management.
  • Current methods may lack sensitivity in identifying subtle pressure-flow abnormalities.

Purpose of the Study:

  • To evaluate pharyngeal automated impedance manometry (AIM) as an objective tool for assessing swallow function in children with dysphagia.
  • To correlate AIM-derived pressure-flow parameters with videofluoroscopic evidence of aspiration.

Main Methods:

  • 20 children with dysphagia underwent simultaneous videofluoroscopy and manometry-impedance.
  • Swallowing events were analyzed using AIM, measuring peak pressure, nadir impedance pressure, time to peak pressure, and flow interval.
  • A swallow risk index (SRI) was calculated from these variables.

Main Results:

  • Six children (30%) exhibited deglutitive aspiration during videofluoroscopy.
  • Longer flow interval, higher SRI, and increased upper esophageal sphincter pressure predicted aspiration risk.
  • AIM-derived pressure-flow variables correlated significantly with aspiration scores.

Conclusions:

  • Pharyngeal AIM offers a novel, non-radiological approach to objectively assess swallow function in children.
  • AIM can detect pressure-flow alterations associated with aspiration risk in pediatric dysphagia.
  • These preliminary findings support AIM's potential as a valuable clinical tool.
Abstract

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