FEES in Infants with Swallowing Disorders - A Feasible Procedure?

Abstract

Although FEES has been established as a valid procedure in instrumental evaluation of swallowing even in young children, the significance of the endoscopic method on infants has not yet been fully clarified. The aim of this prospective study was to evaluate fiberoptic endoscopic examination of swallowing in infants by focusing on its feasibility and limits. From 11/2011 to 3/2015 27 infants from a neuropediatric hospital presented for fiberoptic endoscopic examination of swallowing. Compared with Langmore standard FEES was carried out in a modified algorithm. In 24 of the 27 infants information about swallowing pathology could be obtained. Silent aspiration of saliva (Penetration Aspiration Scale (PAS) level 8) or silent deep penetration of test diets to the level of the glottis (PAS level 5) presented in 10 children and overt deep penetration of test diets in 3 children. In no case a sufficient insight into the subglottis or trachea could be obtained. Therefore a differentiation of silent deep penetration and aspiration of test diets was impossible. As a consequence of the FEES results, probe and diet management was changed in 7 children. In this study fiberoptic endoscopic evaluation of swallowing in a modified algorithm turned out to be a feasible tool for the diagnostics of swallowing disorders in about 89 percent of the infants. The procedure was limited in terms of providing direct evidence on aspiration in cases of deep penetrations of test diets.