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Swallowing therapy appropriate for chronic aspiration in those with normal airway anatomy

Children who aspirated thin or thickened liquids achieved resolution of swallowing dysfunction after a year of therapy, according to study results.

“Most pediatric patients who aspirate thin and thickened liquids will have resolution of their aspiration with appropriate feeding and swallowing therapy within 7.68 and 11.04 months, respectively,” Eelam Adil, MD, MBA, of the department of otolaryngology and communication enhancement at Boston Children’s Hospital, and colleagues wrote. “Syndromic children and those with significant neurologic comorbidities are less likely to progress with therapy and require gastrostomy tube placement,”

Adil and colleagues conducted a retrospective study of 46 pediatric patients (mean age, 1.56 years) who were identified as aspirated through modified barium swallow. They found 16 patients (35%) had a developmental delay, 12 patients (26%) had congenital heart failure and eight patients (17%) were syndromic. Fifteen patients (33%) underwent brain MRI; however, Adil and colleagues noted there were no brainstem lesions or posterior fossa lesions that would explain the aspiration in these patients.

Patients were grouped based on the consistency of their aspirated fluids: 25 patients (54%) aspirated thin liquids, 15 patients (33%) aspirated thickened fluids and six patients (13%) aspirated purees. Therapy effectively treated 21 patients (84%) in the thin liquid group, 12 patients (80%) in the thickened liquid group and three patients (50%) in the puree group. Adil and colleagues noted three patients did not respond to treatment and underwent tracheotomies for their aspiration.

“The investigation and treatment of swallowing problems in children are challenging. Early diagnosis and intervention, including feeding and swallowing therapy, are extremely important to support optimal growth and to prevent pulmonary complications,” Adil and colleagues concluded. – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.