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Updated: Jan 13, 2026
Adapting Human Videofluoroscopic Swallow Study Methods to Detect and Characterize Dysphagia in Murine Disease Models
Published on: March 1, 2015
Evaluation of swallow function in patients with congenital diaphragmatic hernia
Nzuekoh N Nchinda1, Eustina G Kwon2, Carrie Foster3
1Division of Pediatric General and Thoracic Surgery, Seattle Children's Hospital, 4800 Sand Point Way NE, Ocean 9.A.220, Seattle, WA 98105, USA; Department of Surgery, University of Washington, 1959 NE Pacific Street, Box 356410, Seattle, WA 98195, USA.
Insights
Infants with congenital diaphragmatic hernia (CDH) often need feeding tubes. A video fluoroscopic swallow study (VFSS) can detect aspiration, but prenatal indicators are not clear, suggesting a low threshold for swallow evaluation.
Area of Science:
- Pediatric Surgery
- Neonatology
- Gastroenterology
Background:
- Congenital diaphragmatic hernia (CDH) poses risks for lung injury and dysphagia in infants.
- Aspiration is a significant concern in CDH patients, impacting nutritional support and respiratory health.
Purpose of the Study:
- To assess the utilization of video fluoroscopic swallow study (VFSS) for detecting aspiration in infants with CDH.
- To identify prenatal indicators, such as lung-to-head ratio (LHR) and polyhydramnios, associated with swallow dysfunction in CDH infants.
Main Methods:
- Retrospective observational study of 105 infants with CDH.
- Analysis of VFSS results and correlation with prenatal factors (LHR, polyhydramnios).
Main Results:
- Most CDH infants required feeding tubes; less than half underwent VFSS.
- Aspiration was detected in 60% of inpatient VFSS and 35% of outpatient VFSS.
- Prenatal factors (CDH size, LHR, polyhydramnios) were not consistently linked to aspiration.
Conclusions:
- Formal VFSS is underutilized in CDH patients despite feeding difficulties.
- A low threshold for swallow evaluation is recommended due to the lack of reliable prenatal predictors for aspiration.
Purpose:
Children with congenital diaphragmatic hernia (CDH) are vulnerable to lung injury secondary to aspiration and have an elevated risk of dysphagia. This study assesses video fluoroscopic swallow study (VFSS) utilization to detect aspiration and aims to identify prenatal indicators of swallow dysfunction in infants with CDH.
Methods:
This is a single center, retrospective observational study of infants with CDH born between January 2014 and October 2022. VFSS results were analyzed, along with potential associations between aspiration and lung-to-head ratio (LHR) or the presence of polyhydramnios.
Results:
A total of 105 infants were included. The majority of patients were born at term (87, 83 %), had left-sided CDH (81, 77 %), and underwent patch repair (56, 53 %). Most patients (78, 74 %) were discharged with a feeding tube for supplementary nutrition. Twenty patients (19 %) had a VFSS performed prior to discharge, and an additional 29 patients (28 %) completed outpatient VFSS within five years of discharge. The majority of patients with inpatient VFSS (12, 60 %) showed aspiration compared to 10 patients (35 %) who had outpatient VFSS. CDH size, laterality, repair type, LHR, and polyhydramnios were not consistently associated with aspiration on VFSS. For most patients who received inpatient VFSS (11, 92 %), findings resulted in changes in feeding management.
Conclusion:
Although most infants with congenital diaphragmatic hernia required tube feeds due to feeding difficulties, less than half underwent formal VFSS. In the absence of consistent predictors, a low threshold for initiating formal swallow evaluation in patients with CDH is recommended.
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