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Aspiration in the otherwise healthy Infant-Is there a natural course for improvement?

Geoffrey C Casazza1,2, M Elise Graham1,2, Fadi Asfour3,2

  • 1Division of Pediatric Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, U.S.A.

The Laryngoscope
|March 6, 2019
PubMed

Insights

Most infants with aspiration, a swallowing dysfunction, improve within one year without surgery. This study highlights the natural course of recovery in healthy infants, suggesting further research into neurologically normal infant swallowing.

Area of Science:

  • Pediatric Gastroenterology
  • Otolaryngology
  • Speech-Language Pathology

Background:

  • Pediatric oropharyngeal dysphagia management, particularly surgical intervention timing, presents significant challenges.
  • Limited research exists on the natural progression of swallowing dysfunction in otherwise healthy infants.

Purpose of the Study:

  • To evaluate the outcomes and time to resolution of abnormal swallowing in infants diagnosed with aspiration.
  • To understand the natural course of swallowing dysfunction in infants without significant comorbidities.

Main Methods:

  • A retrospective case series was conducted at a tertiary children's hospital.
  • Fifty infants under one year old with aspiration on a modified barium swallow study were included.
  • Exclusion criteria included prematurity (<34 weeks), medical/genetic comorbidities, or prior surgical intervention for aspiration. Patients were followed until aspiration resolved.

Main Results:

  • Forty out of fifty patients (80%) achieved resolution of aspiration.
  • The median time to resolution was 202 days (range: 19-842 days).
  • Resolution probabilities were 46% at 6 months, 64% at 1 year, 76% at 2 years, and 81.3% by the end of follow-up.

Conclusions:

  • The majority of infants with aspiration and no major comorbidities experience improvement within one year.
  • Further research is needed to better understand swallowing dysfunction in neurologically normal infants.
  • This study provides insights into the natural resolution of aspiration in infants, informing clinical management decisions.
Abstract

Keywords:
Oropharyngeal dysphagiaaspirationlaryngologypediatric otolaryngology

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