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Predicting penetration-aspiration through quantitative swallow measures of children: a videofluoroscopic study

Show simple item record Dharmarathna, I. Miles, A. Allen, J. 2021-02-22T06:21:56Z 2021-02-22T06:21:56Z 2021
dc.identifier.citation European Archives of Oto-Rhino-Laryngology.2021. doi: 10.1007/s00405-021-06629-4. [Online ahead of print] en_US
dc.identifier.issn 0937-4477 (Print)
dc.identifier.issn 1434-4726 (Electronic)
dc.identifier.issn 0937-4477 (Linking)
dc.description Indexed in MEDLINE en_US
dc.description.abstract PURPOSE: Quantitative measures have improved the reliability and accuracy in interpretation and reporting of videofluoroscopy (VFSS). Associations between quantitative VFSS measures and swallow safety in children are not widely reported. The ability to predict aspiration in children, even if not observed during brief VFSS, will improve diagnostic reporting and potentially reduce the need for extended radiation time. The aims of this study were to determine associations between quantitative fluoroscopic swallow measures and penetration-aspiration and to predict likelihood of penetration-aspiration. METHODS: We selected videofluoroscopic data of 553 children from a pediatric hospital database for this single-center retrospective observational study. A standard protocol of VFSS administration was used and data were recorded at 30 frames-per-second. A set of quantitative and descriptive swallow measures was obtained using a specialized software with satisfactory inter-rater and intra-rater reliability. Binomial logistic regression with backward likelihood ratio was conducted, while controlling for age, gender, and etiology. RESULTS: We found bolus clearance ratio (BCR), pharyngeal constriction ratio (PCR), duration to hyoid maximal elevation (Hdur), and total pharyngeal transit time (TPT) to be predictive of penetration-aspiration in children. PCR was the most predictive of penetration-aspiration in children (61.5%). Risk of aspiration was more than 100 times, when BCR = ≥ 0.1, TPT = ≥ 2 s, Hdur = > 1 s or PCR = ≥ 0.2 (p < 0.05 for all measures). CONCLUSION: The results confirm the potential of objective quantitative swallow measures in predicting the risk of aspiration in children with dysphagia. These parameters provide predictive measures of aspiration risk that are clinically useful in identifying children of concern, even if no aspiration is observed during VFSS. KEYWORDS: Aspiration; Children; Deglutition disorders; Dysphagia; Fluoroscopy; Swallowing disorders. en_US
dc.language.iso en_US en_US
dc.publisher Springer International en_US
dc.subject swallow measures en_US
dc.title Predicting penetration-aspiration through quantitative swallow measures of children: a videofluoroscopic study en_US
dc.type Article en_US

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