Airway Protection in Children With Dysphagia: A Preliminary Study

Abstract

Purpose : The physiology and pathophysiology of pediatric swallowing are challenging due to anatomical differences. There are only a few videofluoroscopic case studies examining the relationship between physiologic events and aspiration in infants, especially, airway protection mechanisms using temporal measurements. This study examined the airway protection mechanisms using two temporal measurements: the initiation and duration of laryngeal closure between two groups of children who were referred for dysphagia evaluation.BRMethods : Twelve children (8 younger and 4 older children) were patriciate in the study. Initiation of laryngeal closure (ILC) and laryngeal closure duration (LCD) were measured using videofluoroscopic swallowing examinations (VFSEs) with a 100-ms timer for bottle-fed or 2mL thin liquids and/or puree boluses. Two-way analysis of variance (ANOVA) was used at a significance level of p.05.BRResults : Younger children showed longer LCD than older children. There was no significant difference in ILC between younger and older children with dysphagia. The puree had longer ILC and shorter LCD than the thin liquid bolus.BRConclusions : The longer duration of laryngeal closure in younger children may indicate that their anatomical structure is more prone to better protect their airways than older children. Longer ILC and shorter LCD were observed in both children groups who presented penetration or aspiration. These pathophysiological phenomena should be observed closely as indicators of the higher risk of dysphagia. Bolus modification such as thickened liquid may help the children to keep from aspiration.