Evaluating dysphagia severity and duration in children undergoing airway surgery using the functional oral intake...

Dysphagia poses a significant concern, particularly within the pediatric population due to the heightened susceptibility of children to silent aspiration, which can lead to numerous complications such as aspiration pneumonia, failure to thrive, dehydration, and poor quality of life. This study aimed to review the duration and extent of postoperative dysphagia-related symptoms and outcomes.

A retrospective review was conducted to assess the Functional Oral Intake Scale for Children (FOIS), a grading system used to assess the degree of dysphagia, preoperatively and postoperatively in pediatric patients aged < 14 years who underwent airway procedures between January 2020 and February 2024.

A total of 28 patients (mean age, 20.05 ± 23.89 months) underwent 37 airway procedures. Among them, 25 (67.6%) were male. The most frequently performed procedures were balloon dilatation (with or without laser) and supraglottoplasty, each accounting for 27% of the surgeries. Postoperative outcomes revealed a mean dysphagia duration of 17.29 ± 42.55 days, with the longest duration observed in patients undergoing vocal cord lateralization (mean: 106.5 ± 146.37 days). Additionally, the ability to feed orally declined postoperatively, with the proportion of patients capable of oral feeding decreasing from 64.9% (24 patients) preoperatively to 40.5% (15 patients) postoperatively. Overall, the FOIS scores increased in the study population. Preoperatively, 10 patients (27%) were classified as FOIS level 1, compared with six patients (16.2%) postoperatively. Additionally, the number of patients with FOIS level 2 increased from three (8.1%) preoperatively to six (16.2%) postoperatively.

Our study revealed the prevalence and variability of dysphagia in pediatric patients following airway surgery. The duration of postoperative dysphagia in our study population was the longest for vocal fold lateralization procedures, followed by laryngotracheal reconstruction and supraglottoplasty. Children with pre-existing dysphagia, or those who were tube-dependent before surgery, were found to be at a higher risk for experiencing prolonged and persistent feeding difficulties. We highlight the importance of identifying high-risk patients before surgery and routine postoperative swallowing assessments. This should be followed by the involvement of a multidisciplinary care team.