Pharyngeal Dysphagia in Children with Down Syndrome

Abstract

Objective: Swallowing problems in children with Down Syndrome (DS) are poorly understood. In particular, longitudinal examination of pharyngeal dysphagia (PD) in this population has not been performed. This study explores PD in a large group of children with DS to assess the incidence, risk factors, and role of intervention on PD. Method: Twenty-year retrospective chart review; children with DS were identified by ICD-9 codes. Multidisciplinary charts were longitudinally reviewed for medical and surgical interventions of PD. Patients were excluded if records were incomplete or could not be assessed. Results: Two hundred twelve (m = 117, f = 95) children with DS were identified for review. One hundred seventeen (55.2%) patients (m = 67, f = 50) demonstrated PD by video fluoroscopic swallow study (VFSS) with an age range of 0.24 to 24.67 years. The mean age at first diagnosis was 1.69 years. Seventy-eight patients with PD underwent 1 or more surgeries for upper airway obstruction (UAO). A laryngeal cleft was identified in 3 patients. At the time of the study, PD was unresolved in 97 patients (average age = 6.57 years) and resolved in 20 (average age = 6.72 years). Surgical procedures for UAO had no significant impact on PD. Conclusion: This study suggests that PD is common (greater than 50%) and should be routinely explored in children with DS. Laryngeal clefts and surgical intervention for UAO do not appear to play a significant role in PD for DS patients.