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Infants without apparent risk factors with aspiration as a cause of respiratory symptoms - a retrospective study
James Trayer1, Carol Gilmore2, Sara Dallapè2
1Respiratory Department, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland. trayerj@tcd.ie.
Insights
Isolated dysphagia in children often presents with recurrent respiratory infections. While some require long-term feeding support, most children experience symptom resolution within a few years.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Pulmonology
- Clinical Pediatrics
Background:
- Dysphagia (swallowing difficulties) is prevalent in children with prematurity, neuromuscular disorders, or airway issues.
- Limited research exists on children with isolated dysphagia, leading to varied clinical outcome reporting.
- Understanding isolated dysphagia is crucial for accurate diagnosis and management in pediatric populations.
Purpose of the Study:
- To characterize the clinical presentation of pediatric isolated dysphagia.
- To evaluate diagnostic methods, treatment approaches, and clinical outcomes.
- To provide insights into the long-term prognosis of this condition.
Main Methods:
- Retrospective chart review of pediatric patients with isolated dysphagia.
- Study conducted at a tertiary pediatric center over a 10-year period.
- Analysis included clinical presentation, feeding assessments, and radiological findings.
Main Results:
- Seventeen children with isolated dysphagia were identified.
- Recurrent respiratory tract infections were the most common symptom (82%).
- 65% of children achieved symptom resolution and full oral feeds, with a mean age of 3.45 years at resolution. 50% of those requiring gastrostomy tubes had them removed.
Conclusions:
- Recurrent, unexplained respiratory symptoms in children may indicate isolated dysphagia.
- Early consideration of dysphagia is important for timely intervention.
- While resolution can take several years, many children achieve positive long-term outcomes.
Background:
Dysphagia is common in children born prematurely or those with neuromuscular conditions or airway malformations. Few studies have reported on children with isolated dysphagia and there is significant variation in the literature regarding clinical outcomes.
Aims:
The aim of this study was to characterise the clinical presentation of children with isolated dysphagia as well as the diagnostic evaluation, treatment strategies and clinical outcomes.
Methods:
A retrospective chart review was conducted of children with isolated dysphagia presenting to a tertiary paediatric centre over a 10-year period.
Results:
We describe these patients' presentation, clinical feeding assessment findings, radiological findings, treatment strategies and outcomes. Seventeen children were identified. Recurrent respiratory tract infections were the most common presentation (82%). Oral feeds were continued in 9 (53%) with the remaining being NG fed. Gastrostomy tubes were required for long-term nutrition in 6/8 (75%) of these cases. At follow-up, 11/17 (65%) had resolution of symptoms and are on full oral feeds. The mean age at resolution is 3.45 years. Of those who required gastrostomy 50% have had them removed.
Conclusion:
Isolated dysphagia should be considered in children presenting with recurrent, otherwise unexplained respiratory symptoms. Resolution can take a number of years.
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