Silent aspiration prominent in children with dysphagia

Joan Arvedson, Brian Rogers, Germaine Buck, Paulette Smart, Michael Msall

Research output: Contribution to journalArticlepeer-review

153 Scopus citations

Abstract

Children with neurologically-based dysphagia are at high risk for silent aspiration. Aspiration can lead to complications such as acute pneumonia and chronic lung disease. Thorough evaluation of the oral, pharyngeal, and esophageal phases of swallowing is crucial for patients with dysphagia. The videofluoroscopic modified barium swallow study (MBS) is the procedure of choice for children to delineate the pharyngeal and upper esophageal phases of the swallow that can only be inferred by bedside clinical assessment. This study describes attributes of aspiration and pharyngeal motility in a large sample of infants and children assessed with MBS. Aspiration was observed in 48 (26%) of 186 children, primarily on liquid before or during swallows. Aspiration was trace (less than 10% of a bolus) and silent in 94%. Relationships to clinical history and implications for management are discussed. Given the lack of objective clinical information to identify children at risk for aspiration, MBS should be considered in all children with severe dysphagia to rule out or confirm aspiration.

Original languageEnglish (US)
Pages (from-to)173-181
Number of pages9
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume28
Issue number2-3
DOIs
StatePublished - Jan 1994

Keywords

  • Aspiration
  • Clinical evaluation
  • Deglutition
  • Dysphagia
  • Infants and children
  • Pediatrics, developmental
  • Radiography
  • Swallowing dysfunction
  • Videofluoroscopy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Otorhinolaryngology

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