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Adapting Human Videofluoroscopic Swallow Study Methods to Detect and Characterize Dysphagia in Murine Disease Models
Published on: March 1, 2015
The prevalence of Chiari malformation among children with persistent dysphagia
Inbal Hazkani1, Courtney Voyles2, Kartik M Reddy3
1Division of Pediatric Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Insights
Brain MRI is recommended for children with persistent dysphagia due to the prevalence of Chiari malformation (CM). Further studies are needed to define imaging criteria for pediatric dysphagia.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Gastroenterology
Background:
- Persistent pediatric dysphagia evaluation often includes brain imaging.
- Indications and Chiari malformation (CM) prevalence in this context are not well-established.
Purpose of the Study:
- Evaluate CM anomaly prevalence in children with pharyngeal dysphagia undergoing brain MRI.
- Compare clinical findings between CM and non-CM groups.
Main Methods:
- Retrospective cohort study of pediatric patients (2010-2021).
- Included children undergoing brain MRI for dysphagia workup at a tertiary care center.
Main Results:
- 150 patients analyzed; mean age at dysphagia diagnosis 1 ± 3.4 years.
- CM-I found in 3.3% and tonsillar ectopia in 2.7%; similar dysphagia severity in both groups.
- Common comorbidities: prematurity (46.7%), GERD (43.3%), neuromuscular disorders (35.3%).
Conclusions:
- Brain MRI is valuable in pediatric dysphagia workup due to CM-I prevalence.
- Further multi-institutional research needed to establish imaging guidelines for pediatric dysphagia.
Background:
Brain imaging has been utilized as a diagnostic tool in the workup of persistent pediatric dysphagia, yet the indications for imaging and the prevalence of Chiari malformation (CM) have not been established.
Objective:
to evaluate the prevalence of CM anomalies in children who underwent brain magnetic resonance imaging (MRI) for pharyngeal dysphagia and to review the clinical findings in the CM group compared to the non-CM group.
Methods:
A retrospective cohort study of children who underwent MRI as part of the workup for the diagnosis of dysphagia in a tertiary care children's hospital between 2010 and 2021.
Results:
150 patients were included. The mean age at diagnosis of dysphagia was 1 ± 3.4 years, and the mean age at MRI was 3.5 ± 4.2 years. Common comorbidities in our cohort included prematurity (n = 70, 46.7 %), gastroesophageal reflux (n = 65, 43.3 %), neuromuscular/seizure disorder (n = 53,35.3 %), and underlying syndrome (n = 16, 10.7 %). Abnormal brain findings were seen in 32 (21.3 %) patients, of whom 5 (3.3 %) were diagnosed with CM-I and 4 (2.7 %) patients with tonsillar ectopia. Clinical characteristics and dysphagia severity were similar between patients with CM-I/tonsillar ectopia and patients without tonsillar herniation.
Conclusions:
Brain MRI should be pursued as part of the work-up for persistent dysphagia in pediatric patients given the relatively higher prevalence of CM-I. Multi-institutional studies are required to establish the criteria and timing of brain imaging in patients with dysphagia.
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