[Radiological studies of feeding disorders in severely retarded children].
Feeding difficulty is a major problem in severely retarded children. Fourteen patients aged from 5 to 36 years with physical and intellectual impairments who had feeding difficulties were investigated by videofluoroscopy. Video-fluoroscopic findings showed that the liquid was easier to be aspirated than the paste, and that in the sitting position aspirations were more frequent than in the supine. The predisposing factors of feeding difficulties were thought to be poor bolus formation by the tongue, delayed swallowing reflex, incomplete closure of the larynx and poor pharyngeal pressure. Of ten cases that showed markedly gulped air, three of them had gastro-esophageal reflux, which was very likely caused by the increased intragastric pressure. Seven patients fed by nasogastric tube feeding were examined their swallowing ability by dropping contrast medium into the oral cavity. Three patients aspirated contrast media into bronchi. This suggests that they also generally aspirated saliva which resulted in recurrent respiratory infection. It is therefore important to maintain the swallowing function in patients fed by nasogastric tube. Low osmolality water soluble contrast medium was used in this study. There were no complications. This medium is thought to be safer than the standard media of barium solutions or other high osmolality contrast media, especially for the patients who suffer from aspiration.
Kimura
M
M
Department of Pediatrics, National Sanatorium Nishi-Tottori Hospital.
Kato
M
M
Yoshino
K
K
D000293:Adolescent; D002648:Child; D004435:Eating / Q000502:physiology*; D004750:Enteral Nutrition; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008607:Intellectual Disability / Q000503:physiopathology*; D008297:Male; D014741:Video Recording