title: Clinical and fiberoptic endoscopic evaluation of swallowing in Robin sequence treated with nasopharyngeal intubation: the importance of feeding facilitating techniques.
abstract: OBJECTIVE
  To evaluate oral feeding capacity, the swallowing process, and risk for aspiration, both clinically and during fiberoptic endoscopic evaluation of swallowing, in infants with isolated Robin sequence treated exclusively with nasopharyngeal intubation and feeding facilitating techniques.
  
  
  METHODS
  Longitudinal and prospective study.
  
  
  METHODS
  Hospital de Reabilitação de Anomalias Craniofaciais, University of São Paulo, Bauru, Brazil.
  
  
  METHODS
  Eleven infants with isolated Robin sequence, under 2 months of age, treated with nasopharyngeal intubation.
  
  
  METHODS
  Feeding facilitating techniques were applied in all infants throughout the study period. The infants were evaluated clinically and through fiberoptic endoscopic evaluation of swallowing at first, second, and, if necessary, third week of hospitalization (T1, T2, T3). The mean volume of ingested milk was registered during clinical evaluation, and events were registered during feeding.
  
  
  RESULTS
  The respiratory status of all infants was improved after nasopharyngeal intubation; 72% of them presented risk for aspiration during fiberoptic endoscopic evaluation of swallowing at T1. This risk was less frequent when thickened milk was given to the infants and at subsequent evaluations (T2 and T3).
  
  
  CONCLUSIONS
  Nasopharyngeal intubation aids in stabilizing the airway in isolated Robin sequence, but it does not relate directly to feeding. The risk for aspiration was present in most of the infants, mainly during the first week of hospitalization, and improved within a few weeks, after the use of feeding facilitating techniques.
authors.affiliation: Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo (HRAC-USP), Bauru, São Paulo, Brazil. marquesi@usp.br
authors.forename: Ilza Lazarini
authors.initials: IL
authors.lastname: Marques
authors.forename: Rosana
authors.initials: R
authors.lastname: Prado-Oliveira
authors.forename: Vera Helena Valente
authors.initials: VH
authors.lastname: Leirião
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Jorge
authors.forename: Luiz
authors.initials: L
authors.lastname: de Souza
mesh_terms: D000818:Animals; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000209:etiology; D019723:Endoscopes; D016145:Endoscopy, Digestive System / Q000295:instrumentation*; D004750:Enteral Nutrition / Q000295:instrumentation / Q000379:methods*; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007440:Intubation / Q000295:instrumentation*; D007441:Intubation, Gastrointestinal; D007902:Length of Stay; D008137:Longitudinal Studies; D008892:Milk; D009305:Nasopharynx; D055100:Optical Fibers; D010855:Pierre Robin Syndrome / Q000150:complications*; D011446:Prospective Studies; D053120:Respiratory Aspiration / Q000209:etiology; D012131:Respiratory Insufficiency / Q000628:therapy; D012307:Risk Factors; D015430:Weight Gain