Clinical and videofluoroscopic characteristics of oropharyngeal dysphagia in children aged 1 month to 5 years. A study in Medellín, Colombia, 2004

Abstract

Objective: to describe, based on clinical and videofluoroscopic evaluations, the most frequent biomechanical alterations in a group of children, aged 1 month to 5 years, with the clinical suspicion of swallowing disorders.

Methodology: descriptive study of a consecutive sample of 68 patients, between January 1 and December 31, 2004, at a children´s hospital in Medellín, Colombia. Information was obtained by means of a structured survey. The following variables were analyzed: age, sex, personal medical history, and clinical and videofluoroscopic evaluations of the swallowing phases. Statistical analysis was carried out by means of the SPSS 11.0 software.

Results: out of the 68 patients 40 (58.8%) were males. Children between 1- 24 months represented 79.4% of the group. Videofluoroscopy was carried out in 48. Thirty children (44.1%) suffered from cerebral palsy; 11 (16.2%) had congenital oropharyngeal anomalies; 57 (83.8%) had gastrointestinal alterations, the most frequent of which were gastroesophageal reflux and refusal to feed. In 27 (39.7%) there was history of recurrent pneumonia, and 11 (16.2%) more suffered from other respiratory conditions. No significant differences were found in the radiological evaluation of the pharyngeal phase of swallowing between children with or without recurrent pneumonia. Sensitivity of the clinical evaluation was 90% for the oral phase of deglutition, and 91.6% for the pharyngeal phase. There was no agreement between the clinical and radiological evaluations of the swallowing disorder (Kappa 5.6, 95% confidence interval (-0.042-0.154).