New screening test can determine whether children have a swallowing disorder

A simple test to swallow three ounces of water can help determine whether a child has the swallowing disorder oropharyngeal dysphagia, establishing for the first time a way to screen for the ailment in children, according to new research published in the February 2009 issue of Otolaryngology – Head and Neck Surgery.

Oropharyngeal dysphagia is a swallowing disorder caused by abnormalities of muscles, nerves, or structures of the oral cavity, pharynx, and upper esophageal sphincter.

The study issued a three-part challenge to 56 children with suspected oropharyngeal dysphagia. In the first two stages, subjects were asked to swallow food and liquid boluses (large capsules), with aspiration measured using a fiberoptic endoscopic evaluation of swallowing (FEES). Following the first two phases, the patients were then asked to drink and swallow three ounces of water out of a cup or straw.

The researchers concluded that patients who pass the test can begin new diets consisting of not just thin liquids, but also other food consistencies, including pureed, chopped, soft-solid, or regular diet, depending on how much the patient aspirated during the challenge's first two phases.

According the research, 39.3 percent of the patients passed the water swallow challenge, and were cleared for an oral diet, with 86.4 percent of those passing resuming a solid food diet. Furthermore, 61.4 percent of those who failed the test were able to tolerate thin liquids based on FEES results.

Previously, there had been no reliable screening test for children suspected of having oropharyngeal dysphagia. While the prevalence of the ailment in children is unknown, the impact is substantial, and can result in poor weight gain and stunted growth, along with dehydration, oral aversion, and pneumonia. Finding a screening test for children means physicians can avoid diagnosis using a videofluoroscopy (which exposes a child to radiation) or a transnasal endoscopy (which can be uncomfortable).

The research coincides with the February 2009 observance of Kids ENT Health Month, an annual opportunity to educate parents and their children on the various otolaryngic health issues that kids face. More information on Kids ENT Health Month can be found at http://www.entnet.org/kidsENT.

Otolaryngology – Head and Neck Surgery is the official scientific journal of the American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF) and the American Academy of Otolaryngic Allergy (AAOA). The study's authors are Debra M. Suiter, PhD; Steven B. Leder, PhD; and David E. Karas, MD.

Reporters who wish to obtain a copy of the article should contact Matt Daigle at 1-703-535-3754, or at newsroom@entnet.org.

About the AAO-HNS

The American Academy of Otolaryngology – Head and Neck Surgery (www.entnet.org), one of the oldest medical associations in the nation, represents nearly 12,000 physicians and allied health professionals who specialize in the diagnosis and treatment of disorders of the ears, nose, throat, and related structures of the head and neck. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. The organization's vision: “Empowering otolaryngologist-head and neck surgeons to deliver the best patient care.”

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