Related Experiment Videos
Swallowing dysfunction and aspiration in neonates and infants
E Kohda1, H Hisazumi, K Hiramatsu
1Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
Insights
Swallowing dysfunction in infants, particularly cricopharyngeal dysfunction, is linked to aspiration and recurrent pneumonia. Identifying these issues early is crucial for better infant health outcomes.
Area of Science:
- Pediatric Gastroenterology
- Neonatology
- Neurology
Background:
- Swallowing dysfunction and aspiration are significant causes of recurrent pneumonia in children, often with fatal outcomes.
- The precise mechanisms underlying these conditions in infants remain largely unknown.
- Early identification and intervention are critical for managing these potentially life-threatening issues.
Purpose of the Study:
- To evaluate swallowing function in neonates and infants using fluoroscopy.
- To identify the underlying mechanisms of aspiration and their association with neurological disorders and sudden infant death syndrome.
- To correlate fluoroscopic findings with clinical outcomes in a pediatric population.
Main Methods:
- Fluoroscopic swallowing examinations were performed on 72 neonates and infants.
- Videotape or digital imaging systems were used to record examination results.
- A subset of 39 patients was followed for over one year to track their clinical course.
Main Results:
- Cricopharyngeal dysfunction was observed in all 10 patients with neurological disorders.
- Nasopharyngeal reflux and cricopharyngeal dysfunction were noted in patients with near-miss sudden infant death syndrome.
- Laryngeal elevation was absent in 75% of patients; cricopharyngeal dysfunction was present in 29 patients without neurological disorders, with transient symptoms in some.
Conclusions:
- Cricopharyngeal dysfunction is a key factor in infant aspiration, particularly in those with neurological conditions, leading to prolonged symptoms.
- Two distinct types of aspiration were identified: one transient, related to pharyngeal and lingual muscle function without neurological links, and another prolonged, associated with cricopharyngeal dysfunction and neurological disease.
- While patients without neurological disorders generally recovered well, prolonged aspiration necessitates further investigation and management strategies.
Abstract:
In children, swallowing dysfunction and aspiration are common causes of recurrent pneumonia and can be fatal. The underlying mechanism is still unknown. In this study, we evaluated the swallowing function in 72 neonates and infants by fluoroscopy and followed the course of 39 patients for more than one year. The results of all the examinations were recorded on videotape or a digital imaging system. All 10 patients with neurologic disorder presented cricopharyngeal dysfunction. Of the 12 patients with near miss sudden infant death syndrome, 10 showed nasopharyngeal reflux, and 5 demonstrated cricopharyngeal dysfunction. In the 50 patients without neurologic disorder, 29 revealed cricopharyngeal dysfunction. Laryngeal elevation was not seen in 75%. Three of these 29 patients had no other abnormality. All patients without neurologic disorder recovered well. Seven patients demonstrated prolonged aspiration. Four of them had neurologic disorder, and the rest had near miss sudden infant death syndrome. Fluoroscopic examination showed two types of aspiration: one was caused not only by pharyngeal but also by lingual muscles. It was not associated with any neurologic disorders and the symptoms were transient. The other was caused by cricopharyngeal dysfunction and most of these patients had neurologic diseases and prolonged symptoms.