Prognosis

The prognosis depends on underlying conditions that predispose to impaired sucking and swallowing. However, the early recognition of feeding problems, the diagnosis of underlying disorders and appropriate intervention improve outcomes for the child and the family.

Table 15.4 Swallowing strategies for pediatric dysphagia

Behavioral training Dietary modification thickened liquids thin liquids

Proper intrabolus placement modification of feeding utensils and bolus presentation

Swallowing exercises supraglottic swallow supersupraglottic swallow effortful swallow Mendelsohn maneuver

Modification of body tone, posture, seating and positioning head tilt chin tuck head rotation lying on the side, elevation

Suckle-feeding-valved feeding bottle

Crycopharyngeal myotomy

Facilitatory techniques biofeedback thermal stimulation gustatory stimulation

Provision of alternative means of enteral nutrition nasogastric feeding gastrostomy tube (surgical or endoscopic)

REFERENCES

  1. Tuchman DN. Disorders of deglutition. In Walker WA, Durie PR, Walker-Smith JA, Watkins JB, eds. Pediatric Gastrointestinal Disease, 3rd edn. Hamilton, Ontario, Canada: BC Decker, 2000: 277-288.
  2. Rudolph CD, Link DT. Feeding disorders in infants and children. Pediatr Clin North Am 2002; 49: 97-112.
  3. Del Giudice E, Staiano A, Capano G et al. Gastrointestinal manifestations in children with cerebral palsy. Brain Dev 1999; 21: 307-311.
  4. Loughlin GM, Lefton-Greif MA. Dysfunctional swallowing and respiratory disease in children. Adv Pediatr 1994; 41: 135-162.
  5. Cohen SR. Difficulty with swallowing. In Bluestone CD, Stool SE, Arjona SK, eds. Pediatric Otolaryngology. Philadelphia: WB Saunders, 1983.
  6. Wolff Ph. The serial organization of sucking in the young infant. Pediatrics 1968; 42: 943-956.
  7. Mizuno K, Ueda A. The maturation and coordination of sucking, swallowing, and respiration in preterm infants. J Pediatr 2003; 142: 36-40.
  8. Mathew OP. Science of bottle-feeding. J Pediatr 1991; 119: 511-519.
  9. Derkay CS, Schecter GL. Anatomy and physiology of pediatric swallowing disorders. Otolaryngol Clin North Am 1998; 31: 397-404.
  10. Miller AJ. Deglutition. Physiol Rev 1982; 62: 129-184.
  11. Morrell RM. The neurology of swallowing. In Groher ME, ed. Dysphagia and Management. Boston: Butterworth, 1984: 3.
  12. Bosma JF. Postnatal ontogeny of performances of the pharynx, larynx, and mouth. Am Rev Respir Dis 1985; 131: S10-S15.
  13. Tuchman DN. Dysfunctional swallowing in the pediatric patient: clinical considerations. Dysphagia 1988; 2: 203-208.
  14. Stevenson RD, Allaire JH. The development of normal feeding and swallowing. Pediatr Clin North Am 1991; 38: 1439-1453.
  15. Rudolph CD. Diagnosis and management of children with feeding disorders. In Hyman P, Di Lorenzo C, eds. Gastrointestinal Motility Disorders in Children. New York: Academy Professional Information Services, 1994: 33-54.
  16. Darrow DH, Harley CM. Evaluation of swallowing disorders in children. Otolaryngol Clin North Am 1998; 31: 405-418.
  17. Illingworth RS, Lister J. The critical or sensitive period, with special reference to certain feeding problems in infants and in children. J Pediatr 1964; 65: 839-843.
  18. Cook IJ, Kahrilas PJ. AGA technical review on management of oropharyngeal dysphagia. Gastroenterology 1999; 116: 455-478.
  19. Logemann JA. Evaluation and Treatment of Swallowing Disorders. San Diego, CA: College Hill, 1983.
  20. Dodds WJ, Stewart ET, Logemann JA. Physiology and radiology of the normal oral and pharyngeal phases of swallowing. Am J Roentgenol 1990; 154: 953-963.
  21. Mendelsohn M. New concepts in dysphagia management. J Otolaryngol 1993; 22 (Suppl 1): 1-24.
  22. McConnel FMS. Analisys of pressure generation and bolus transit during pharyngeal swallowing. Laryngoscope 1988; 98: 71-78.
  23. McConnel FM, Cerenko D, Mendelsohn MS. Dysphagia after total laryngectomy. Otolaryngol Clin North Am 1988; 21: 721-726.
  24. Curtis DJ, Cruess DF, Dachman AH. Normal erect swallowing. Normal function and incidence of variations. Invest Radiol 1985; 20: 717-726.
  25. Sivarao DV, Goyal RK. Functional anatomy and physiology of the upper esophageal sphincter. Am J Med 2000; 108 (Suppl 4a): 27S-37S.
  26. Palmer ED. Disorders of the cricopharyngeus muscle: a review. Gastroenterology 1976; 71: 510-519.
  27. Staiano A, Cucchiara S, De Vizia B et al. Disorders of upper esophageal sphincter motility in children. J Pediatr Gastroenterol Nutr 1987; 6: 892-898.
  28. Leslie P, Carding PN, Wilson JA. Investigation and management of chronic dysphagia. BMJ 2003; 326: 433-436.
  29. Myer CM. Sialorrea. Pediatr Clin North Am 1989; 36: 1495-1500.
  30. Loughlin GM. Respiratory consequences of dysfunctional swallowing and aspiration. Dysphagia 1989; 3: 126-310.
  31. Durand M, Leahy FN, MacCallum M et al. Effect of feeding on the chemical control of breathing in the newborn infant. Pediatr Res 1981; 15: 1509-1512.
  32. Thach BT. Maturation and transformation of reflexes that protect the laryngeal airway from liquid aspiration from fetal to adult life. Am J Med 2001; 111 (Suppl 8A): 69S-77S.
  33. Hoekstra RE, Perkett EA, Dugan M, Knox GE. Follow-up of the very low birth weight infant (less than 1251 grams). Minn Med 1983; 66: 611-613.
  34. Tuchman DN. Cough, choke, spitter: the evaluation of the child with dysfunctional swallowing. Dysphagia 1989; 3: 111-116.
  35. Rogers BT, Arvedson J, Msall M, Demerath RR. Hypoxemia during oral feeding of children with severe cerebral palsy. Dev Med Child Neurol 1993; 35: 3-10.
  36. Berquist WE, Ament ME. Upper GI function in sleeping infants. Am Rev Respir Dis 1985; 131: S26-S29.
  37. Boyle JT, Tuchman DN, Altschuler SM et al. Mechanisms for the association of gastroesophageal reflux and bronchospasm. Am Rev Respir Dis 1985; 131: S16-S20.
  38. Smith CH, Logemann JA, Colangelo LA et al. Incidence and patient characteristics associated with silent aspiration in the acute care setting. Dysphagia 1999; 14: 1-7.
  39. Sonies BC. Swallowing disorders and rehabilitation techniques. J Pediatr Gastroenterol Nutr 1997; 25 (Suppl 1): S32-S33.
  40. Kramer SS, Eicher PM. The evaluation of pediatric feeding abnormalities. Dysphagia 1993; 8: 215-224.
  41. American Gastroenterological Association. American Gastroenterological Association Medical Position Statement on Management of Oropharyngeal Dysphagia. Gastroenterology 1999; 116: 452-454.
  42. Kovar AJ. Nutrition assessment and management in pediatric dysphagia. Semin Speech Lang 1997; 18: 39-49.
  43. Babbitt RL, Hoch TA, Coe DA et al. Behavioral assessment and treatment of pediatric feeding disorders. J Dev Behav Pediatr 1994; 15: 278-291.
  44. Gisel EG, Alphonce E, Ramsay M. Assessment of ingestive and oral praxis skills: children with cerebral palsy vs. controls. Dysphagia 2000; 15: 236-244.
  45. Ekberg O, Olsson R, Bulow M. Radiologic evaluation of dysphagia. Abdom Imag 1999; 24: 444.
  46. Bu'Lock F, Woolridge MW, Baum JD. Development of coordination of sucking, swallowing and breathing: ultrasound study of term and preterm infants. Dev Med Child Neurol 1990; 32: 669-678.
  47. Rudolph CD. Feeding disorders in infants and children. Pediatrics 1994; 125: S116-S124.
  48. Hila A, Castell JA, Castell DO. Pharyngeal and upper esophageal sphincter manometry in the evaluation of dysphagia. J Clin Gastroenterol 2001; 33: 355-361.
  49. Broniatowski M, Sonies BC, Rubin JS et al. Current evaluation and treatment of patients with swallowing disorders. Otolaryngol Head Neck Surg 1999; 120: 464-473.
  50. Langmore SE, Schatz K, Olsen N. Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia 1988; 2: 216-219.
  51. Hamlet SL, Mutz J, Patterson, R, Jones L. Pharyngeal transit time: assessment with videofluoroscopic and scintigraphic techniques. Dysphagia 1989; 4: 4-7.
  52. Silver KH, Nostrand DV. Scintigraphic detection of salivary aspiration: description of a new diagnostic technique and case reports. Dysphagia 1992; 7: 45-49.
  53. Logemann JA. Role of the modified barium swallow in management of patients with dysphagia. Otolaryngol Head Neck Surg 1997; 116: 335-338.
  54. Arvedson JC. Management of pediatrics dysphagia. Otolaryngol Clin North Am 1998; 31: 453-476.
  55. Babbitt RL, Hoch TA, Coe DA et al. Behavioral assessment and treatment of pediatric feeding disorders. J Dev Behav Pediatr 1994; 15: 278-291.
  56. Helfrich-Miller KR, Rector KL, Straka JA. Dysphagia: its treatment in the profoundly retarded patient with cerebral palsy. Arch Phys Rehabil 1986; 67: 520-525.
  57. Croghan JE, Burke EM, Caplan S, Denman S. Pilot study of 12-month outcomes of nursing home patients with aspiration on videofluoroscopy. Dysphagia 1994; 9: 141-146.
  58. Groher ME. Bolus Management and aspiration pneumonia in patient with pseudobulbar dysphagia. Dysphagia 1987; 1: 215-216.
  59. Shaker R, Easterling C, Kern M et al. Rehabilitation of swallowing by exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES opening. Gastroenterology 2002; 122: 1314-1321.

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Herbal Remedies For Acid Reflux

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