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Published on: June 13, 2017
Efficacy and Complications of Interarytenoid Injection for Dysphagia in Infants 1-Year-Old and Under
Trenton House1, Patrick Scheffler2,3, Mark E Gerber2
1University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA.
Insights
Interarytenoid injection augmentation (IAIA) effectively treats dysphagia in infants, showing significant improvements in swallowing function and low complication rates. Further research is needed to evaluate the impact of concurrent feeding therapy (FT) on outcomes.
Area of Science:
- Pediatric Otolaryngology
- Swallowing Disorders
- Pediatric Gastroenterology
Background:
- Dysphagia in infants presents significant feeding and respiratory challenges.
- Interarytenoid injection augmentation (IAIA) is a potential treatment for pediatric dysphagia.
- The efficacy and safety of IAIA in very young children require further investigation.
Purpose of the Study:
- To assess the efficacy and complication rates of IAIA for dysphagia in infants under 13 months.
- To determine if concurrent feeding therapy (FT) influences the outcomes of IAIA.
Main Methods:
- Retrospective case series of 65 patients aged 13 months or younger with dysphagia.
- Treatment involved interarytenoid injection augmentation (IAIA).
- Efficacy assessed via videofluoroscopic swallow studies (VFSS) and Dysphagia Outcome and Severity Scale (DOSS) scores; complications and FT use reviewed.
Main Results:
- Significant improvements observed in postoperative VFSS scores (67% improved) and DOSS scores (56% improved).
- Most patients (92%) were discharged on the day of surgery with a low 30-day readmission rate (5%).
- No intraoperative or severe long-term complications were reported; no statistical difference in outcomes was found for the concurrent FT group due to sample size limitations.
Conclusions:
- IAIA demonstrates comparable success and complication rates in infants to those reported in older pediatric populations.
- The procedure is safe for young children, with most patients experiencing rapid discharge and no severe complications.
- Further research is necessary to elucidate the role and impact of concurrent feeding therapy (FT) on IAIA outcomes.
Objective:
The objective of this study was to assess the efficacy and complication rates of interarytenoid injection augmentation (IAIA) for the treatment of dysphagia in patients 1 year of age and under and to determine if concurrent feeding therapy (FT) affects outcome.
Study Design:
Retrospective case series.
Setting:
Tertiary pediatric hospital.
Methods:
Retrospective review of patients 13 months of age and younger with dysphagia treated by IAIA over a 4-year period. The efficacy of IAIA was determined by comparing perioperative videofluoroscopic swallow studies (VFSS) and Dysphagia Outcome and Severity Scale (DOSS) scores. Complication rates and utilization of concomitant FT were determined by evaluating postoperative admission and follow-up records.
Results:
Sixty-five patients met inclusion criteria (median age 8 months, interquartile range [IQR]: 7-11). Sixty-seven percent of patients improved on postoperative VFSS scores (median improvement in aspiration of 2 thickness levels, IQR 0-3, P < .0001), and 56% improved in DOSS scores (median increase of 1, IQR: 0-1.5, P < .0001). Ninety-two percent of patients were discharged home on the day of surgery. The 30-day relevant readmission rate was 5%. No patients had intraoperative complications or severe complications at follow-up. No statistical difference in aspiration or DOSS was noted in the concomitant FT cohort due to a lack of sample size.
Conclusion:
This study demonstrates that IAIA in children under 13 months old shows comparable rates of success and complications to older patients reported in the literature. No patients had long-term complications and most were discharged home on the day of surgery. More studies are needed to determine the effect of concomitant FT on IAIA.
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