Dysphagia in Pediatric Patients with Tracheostomy

Area of Science:

• Pediatric Otolaryngology
• Swallowing Disorders
• Pediatric Critical Care

Background:

• Swallowing function post-tracheotomy in children is not well-documented.
• Tracheotomy may alter swallowing anatomy and physiology.
• Objective assessment of swallowing is needed for pediatric patients.

Purpose of the Study:

• To compare pre- and post-tracheotomy swallowing function in pediatric patients.
• To investigate factors associated with postoperative dysphagia, including tracheotomy indication, age, and timing of modified barium swallow (MBS).

Main Methods:

• Retrospective chart review of 233 pediatric patients who underwent tracheotomy and post-operative MBS.
• Analysis included descriptive statistics, logistic regression, and Fisher's exact test.
• Data collected from 2003 to 2018.

Main Results:

• Nearly half of patients (42.1%) showed improved swallowing function post-tracheotomy.
• Neurological disease as an indication for tracheotomy was linked to a higher likelihood of remaining nil per os (NPO).
• Post-tracheotomy MBS recommendations varied, with 30.9% needing thickened liquids, 42.5% thin liquids, and 26.6% remaining NPO.

Conclusions:

• Tracheotomy can significantly affect pediatric swallowing function.
• Most patients in the study resumed some form of oral diet after tracheotomy.
• Objective swallowing evaluations are essential for safe and timely oral feeding post-tracheotomy.