Dysphagia in children with repaired oesophageal atresia.

Sandra A F De Groot,Catelijne H Coppens,Lenie Van Den Engel-Hoek,Horst Scharbatke,Jos M.T Draaisma

doi:10.1007/s00431-016-2760-4

Abstract

Dysphagia is a common problem in children with repaired oesophageal atresia (OA). Abnormalities in the oropharyngeal and oesophageal phase have hardly been studied. The aims of this study were to assess the prevalence of dysphagia in children with repaired OA and to identify and differentiate oral and pharyngeal dysphagia based on videofluoroscopic swallow study (VFSS) findings in a limited number of children in this cohort. Medical records of 111 patients, born between January 1996 and July 2013 and treated at the Radboudumc Amalia Children’s Hospital, were retrospectively reviewed. The prevalence of dysphagia was determined by the objective and modified Functional Oral Intake Scale (FOIS) in four age groups. The first performed VFSS of 12 children was structurally assessed. The prevalence of dysphagia was 61 of 111 patients (55 %) in age group <1 year. In age group 1–4, 5–11 and 12–18 years, the prevalence of dysphagia decreased from 54 of 106 (51 %) patients to 11 of 64 (17 %) and 5 of 24 (21 %) patients. The 12 VFSS’s reviews revealed oral dysphagia in 36 % and pharyngeal dysphagia in 75 %.Conclusions: This study highlights dysphagia as an important problem in different age groups of children with repaired OA. Furthermore, our study shows the presence of oropharyngeal dysphagia in this population. This study emphasizes the need to standardize the use of objective dysphagia scales, like the modified FOIS, to provide a careful follow-up of children with repaired OA. What is Known: • Prevalence of dysphagia in children with repaired oesophageal atresia varies widely (ranges from 45 to 70 %) in literature. • Oral, pharyngeal and oesophageal dysphagia require different treatment approaches. What is New: • We determined dysphagia based on functional oral intake and provide an overview of change in dysphagia prevalence and severity over time in children with repaired OA. • Our study shows that dysphagia, including oropharyngeal dysphagia, is highly prevalent in young children with repaired OA and improves with time.

Highlights

MethodsA retrospective cohort study in patients with Oesophageal atresia (OA), born between January 1996 and July 2013, was performed at the Radboudumc Amalia Children’s Hospital, Nijmegen, the Netherlands
Our study shows the presence of oropharyngeal dysphagia in this population
This study emphasizes the need to standardize the use of objective dysphagia scales, like the modified Functional Oral Intake Scale (FOIS), to provide a careful follow-up of children with repaired Oesophageal atresia (OA)

Summary

Methods

A retrospective cohort study in patients with OA, born between January 1996 and July 2013, was performed at the Radboudumc Amalia Children’s Hospital, Nijmegen, the Netherlands. Patients with OA treated in this tertiary paediatric centre were identified using the OA registration list of the Paediatric Surgery Department and were included in the clinical cohort. Patients with any of the following criteria were excluded: death within the first 6 months of life, patients with a follow-up less than 6 months, patients lost to follow-up or no available paediatric and paediatric surgery medical records. The medical records were reviewed from birth through December 2014. All first VFSSs of the included patients with repaired OA performed at the research location were identified. All included VFSSs were performed between June 2002 and November 2014. Patients included in the VFSS review will be referred to as ‘VFSS cohort’

Results

Discussion

Conclusion