Simple test determines whether children have oropharyngeal dysphagia swallowing disorder

Feb 2 2009

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).