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Clinical predictors of laryngotracheoesophageal clefts and tracheoesophageal fistulae in children with dysphagia.
Mattos, Claudia; Phinizy, Pelton; Duffy, Kimberly L; Sobol, Steven; Piccione, Joseph.
Afiliación
  • Mattos C; Department of Pediatrics, Nicklaus Children's Hospital, Coral Terrace, Florida, USA.
  • Phinizy P; Division of Pulmonary & Sleep Medicine, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
  • Duffy KL; Department of Speech-Language Pathology, Center for Childhood Communication, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  • Sobol S; Division of Otolaryngology, Department of Otorhinolaryngology-Head & Neck Surgery, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
  • Piccione J; Division of Pulmonary & Sleep Medicine, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Pediatr Pulmonol ; 56(12): 3792-3795, 2021 12.
Article en En | MEDLINE | ID: mdl-34387933
Laryngotracheoesophageal clefts (LTECs) and tracheoesophageal fistulae (TEF) are important structural causes of aspiration requiring bronchoscopy for diagnosis. Determining which children are at greatest risk for LTEC and TEF would enable clinicians to be more selective in performing bronchoscopy. METHODS: Medical records of children aged 0-18 years who underwent flexible and rigid bronchoscopy for evaluation of dysphagia with aspiration were collected and analyzed to identify predictors of LTEC and TEF. RESULTS: Seventy-two children age 2 months to 9 years were identified. LTEC was identified in 19 (26%) and TEF was identified in 1 (1.3%). One-third of the cohort was born preterm (median gestational age 34 weeks). The proportion of LTEC in those born preterm was lower than that of those born full-term (12% vs. 34%, p = .03). There was no statistically significant difference in LTEC prevalence based on age, midline defects, laryngomalacia, tracheomalacia, history of TEF repair, silent aspiration, or viscosity of barium aspirated during videofluoroscopic swallowing studies. Bronchoalveolar lavage fluid cytology, lipid-laden macrophage proportions, and culture results were similar among those with and without LTEC. CONCLUSION: Children with dysphagia and tracheal aspiration born full-term are three times more likely to have LTEC than those born preterm. Dysphagia in children with a history of preterm birth is more likely to be functional as opposed to structural, however, LTEC was identified in approximately 10% of these children and must be considered. These results support the role of bronchoscopy in children with dysphagia with tracheal aspiration.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos de Deglución / Fístula Traqueoesofágica / Nacimiento Prematuro Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Humans / Infant / Newborn Idioma: En Revista: Pediatr Pulmonol Asunto de la revista: PEDIATRIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos de Deglución / Fístula Traqueoesofágica / Nacimiento Prematuro Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Humans / Infant / Newborn Idioma: En Revista: Pediatr Pulmonol Asunto de la revista: PEDIATRIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos