Swallowing in children with neurologic disorders: clinical and videofluoroscopic evaluations.
BACKGROUND
swallowing in children with neurologic disorders.


OBJECTIVE
to relate the data obtained in the clinical and in the videofluoroscopic evaluations of swallowing in children with neurologic disorders.


METHODS
a retrospective analysis of 24 protocols of speech-language evaluation and of medical records of children, of both genders, referred to clinical and videofluoroscopic evaluations of swallowing at the School of Medicine of Ribeirão Preto - University of São Paulo, from January 2001 to June 2005. The following aspects were analyzed in the clinical evaluation: diet consistency, functional aspects of the swallowing mechanism and results of the cervical auscultation. Videofluoroscopic evaluation was performed to determine the dynamic aspects of the oral and pharyngeal phases.


RESULTS
during the clinical evaluation of the oral phase, for both liquid and pasty consistencies, a greater occurrence of inadequate bolus control was observed (n = 15 e n = 14, respectively). In the pharyngeal phase, also for both consistencies, an adequate cervical auscultate was more frequently observed before swallowing (n = 16 e n = 13) followed by the inadequate cervical auscultation during swallowing (n = 15 e n = 12). In the videofluoroscopic evaluation, during the oral phase, for both consistencies, the presence of inadequate food propulsion was the most frequent finding (n = 13 e n = 13) and, in the pharyngeal phase, the most frequent finding was the absence of laryngotracheal aspiration (n = 12 e n = 17). There was a statistically significant correlation between the cervical auscultate and the excursion of the hyoid and the larynx, and between the cervical auscultate and laryngotracheal aspiration of liquid and pasty consistencies.


CONCLUSIONS
both procedures are important and complementary in the diagnosis of dysphagia.
Marrara
Jamille Lays
JL
Departamento de Engenharia Elétrica de São Carlos, Universidade de São Paulo. jmarrara@sel.eesc.usp.br
Duca
Ana Paula
AP
Dantas
Roberto Oliveira
RO
Trawitzki
Luciana Vitaliano Voi
LV
Lima
Raquel Aparecida Cardozo de
RA
Pereira
José Carlos
JC
D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D002675:Child, Preschool; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010614:Pharynx / Q000503:physiopathology; D012189:Retrospective Studies; D014743:Videotape Recording