Pressure-Flow Analysis for the Assessment of Pediatric Oropharyngeal Dysphagia

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• 作者：Lara Ferris ; MSp¹ ; ² ; ^{lara.ferris@sa.gov.au" class="auth_mail" title="E-mail the corresponding author} ; Nathalie Rommel ; PhD³ ; Sebastian Doeltgen ; PhD⁴ ; Ingrid Scholten ; EdD⁴ ; Stamatiki Kritas ; BSc¹ ; Rammy Abu-Assi ; MD¹ ; Lisa McCall ; EN¹ ; Grace Seiboth ; BSc¹ ; Katie Lowe ; BSc¹ ; David Moore ; MD¹ ; Jenny Faulks ; BApS⁵ ; Taher Omari ; PhD²
• 关键词：pressure flow analysis ; manometry ; motility ; impedance ; oropharyngeal dysphagia
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：177
• 期：Complete
• 页码：279-285.e1
• 全文大小：722 K

文摘

To determine which objective pressure-impedance measures of pharyngeal swallowing function correlated with clinically assessed severity of oropharyngeal dysphagia (OPD) symptoms.

Study design

Forty-five children with OPD and 34 control children without OPD were recruited and up to 5 liquid bolus swallows were recorded with a solid-state high-resolution manometry with impedance catheter. Individual measures of pharyngeal and upper esophageal sphincter (UES) function and a swallow risk index composite score were derived for each swallow, and averaged data for patients with OPD were compared with those of control children without OPD. Clinical severity of OPD symptoms and oral feeding competency was based on the validated Dysphagia Disorders Survey and Functional Oral Intake Scale.

Results

Those objective measures that were markers of UES relaxation, UES opening, and pharyngeal flow resistance differentiated patients with and without OPD symptoms. Patients demonstrating abnormally high pharyngeal intrabolus pressures and high UES resistance, markers of outflow obstruction, were most likely to have signs and symptoms of overt Dysphagia Disorders Survey (OR 9.24, P = .05, and 9.7, P = .016, respectively).

Conclusion

Pharyngeal motor patterns can be recorded in children by the use of HRIM and pharyngeal function can be defined objectively with the use of pressure-impedance measures. Objective measurements suggest that pharyngeal dysfunction is common in children with clinical signs of OPD. A key finding of this study was evidence of markers of restricted UES opening.