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https://hdl.handle.net/2440/97626
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Type: | Journal article |
Title: | Objective assessment of swallow function in children with suspected aspiration using pharyngeal automated impedance manometry |
Author: | Rommel, N. Selleslagh, M. Hoffman, I. Smet, M. Davidson, G. Tack, J. Omari, T. |
Citation: | Journal of Pediatric Gastroenterology and Nutrition, 2014; 58(6):789-794 |
Publisher: | Lippincott Williams & Wilkins |
Issue Date: | 2014 |
ISSN: | 0277-2116 1536-4801 |
Statement of Responsibility: | Nathalie Rommel, Margot Selleslagh, Ilse Hoffman, Maria H. Smet, Geoffrey Davidson, Jan Tack, Taher Imad Omari |
Abstract: | OBJECTIVES: The purpose of the present study was to apply a new method, pharyngeal automated impedance manometry (AIM), as an objective assessment tool of swallow function relevant to aspiration, in a cohort of paediatric patients with dysphagia. METHODS: We studied 20 children (mean age 6 years [5 months to 13.4 years]) referred for videofluoroscopy to assess aspiration risk with simultaneous manometry-impedance. Fluoroscopic evidence of aspiration was scored using a validated aspiration-penetration score. Pressure-flow profiles were analysed using AIM analysis measuring peak pressure, pressure at nadir impedance, time from nadir impedance to peak pressure, and flow interval. These variables were combined into a swallow risk index (SRI). RESULTS: Six of 20 children presented with deglutitive aspiration during videofluoroscopic assessment of swallowing. Of 58 liquid swallows analysed, in 9 aspiration was observed. Multiple logistic regression identified longer flow interval (P < 0.05), higher SRI (P < 0.05) and increased pressure in the upper oesophageal sphincter during maximal bolus flow (P < 0.05) to be the dominant risk variables predictive of aspiration in children. Each of these nonradiologically derived pressure-flow variables correlated with higher aspiration scores on videofluoroscopy (P < 0.01). CONCLUSIONS: We present novel, preliminary findings in children with deglutitive aspiration, suggesting that pharyngeal AIM can detect alterations in pressure-flow characteristics of swallowing that predispose to aspiration risk. |
Keywords: | Esophageal Sphincter, Upper Pharynx Deglutition Disorders Fluoroscopy Logistic Models Manometry Electric Impedance Deglutition |
Rights: | Copyright status unknown |
DOI: | 10.1097/MPG.0000000000000337 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/1009344 |
Published version: | http://dx.doi.org/10.1097/mpg.0000000000000337 |
Appears in Collections: | Aurora harvest 7 Medicine publications |
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