[Functional endoscopic evaluation of swallowing in infants with deglutition disorders]

I Partida-Justo1, J E Israel Grijalva-Otero2, J L Ramírez-Figueroa3

  • 1Hospital General Regional N° 2 con Unidad Médica de atención ambulatoria.

Insights

Functional endoscopic evaluation of swallowing (FEES) accurately diagnoses infant deglutition disorders (DD) compared to videofluoroscopy. FEES demonstrates high sensitivity and specificity for aspiration, penetration, and gastroesophageal reflux in infants.

Area of Science:

  • Pediatric Gastroenterology
  • Otolaryngology
  • Speech-Language Pathology

Background:

  • Deglutition disorders (DD) in infants present diagnostic challenges.
  • Functional endoscopic evaluation of swallowing (FEES) shows promise but requires validation in pediatric populations.
  • Videofluoroscopy (VF) is the current gold standard for evaluating infant swallowing.

Purpose of the Study:

  • To compare the diagnostic accuracy of FEES with VF in infants suspected of having DD.
  • To establish FEES as a reliable tool for pediatric dysphagia assessment.

Main Methods:

  • A comparative study involving 66 infants with suspected DD.
  • FEES and VF were performed on all participants.
  • Sensitivity, specificity, PPV, NPV, and likelihood ratios were calculated for FEES findings.

Main Results:

  • FEES demonstrated high sensitivity (98%) for aspiration and penetration.
  • FEES showed high specificity (94-95%) for spillage and waste.
  • Agreement between FEES and VF for spill and penetration was substantial (0.81).

Conclusions:

  • FEES is a sensitive (80.8%) and specific (85.3%) tool for diagnosing infant DD.
  • FEES shows good concordance (kappa=0.815) with VF for identifying suction abnormalities.
  • FEES offers a viable alternative for evaluating pediatric dysphagia.
Abstract

Related Concept Videos

Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
1.3K
Upper GI Series: Barium Swallow01:24

Upper GI Series: Barium Swallow

The Barium Swallow Study, or a Barium Esophagogram, is a diagnostic imaging method used to visualize the upper gastrointestinal (GI) tract, including the esophagus, stomach, and small intestine. It employs barium sulfate, a radiopaque contrast material, to provide clear images of the upper digestive system, helping to identify abnormalities, diseases, or structural issues.
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
1.8K
Enteral Nutrition I: Orogastric and Nasogastric Feeding01:26

Enteral Nutrition I: Orogastric and Nasogastric Feeding

Enteral nutrition delivers nutrients directly to the stomach or small intestine through a tube. This method is appropriate for patients who cannot eat but still have a functioning digestive system. It is also beneficial for individuals with swallowing difficulties, anorexia, malabsorption, or those who have undergone gastrointestinal (GI) surgery.
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
1.7K
Endoscopic Procedures III: Video Capsule Endoscopy01:28

Endoscopic Procedures III: Video Capsule Endoscopy

Capsule endoscopy, or wireless or video capsule endoscopy, is a diagnostic procedure for examining the entire gastrointestinal tract. Patients swallow a capsule about the size of a vitamin tablet. The capsule is equipped with a transmitter, a battery, an LED light source, and a color video camera to capture images throughout the gastrointestinal tract. This procedure is particularly useful for diagnosing conditions such as Crohn's disease, ulcerative colitis, tumors, polyps, ulcers,...
920
Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
3.9K
Deglutition01:25

Deglutition

Swallowing, otherwise known as deglutition, facilitates the transport of food from the mouth to the stomach. It is a multifaceted process that involves both the tongue and the muscles of the throat and esophagus. Saliva and mucus aid in this process, which takes approximately 4 to 8 seconds for semi-solid or solid food and around 1 second for liquids or very soft food.
Swallowing can be divided into three stages: the voluntary phase, the pharyngeal phase, and the esophageal phase. Although the...
6.3K