Efficacy of Predicting Videofluoroscopic Results in Dysphagic Patients with Severe Cerebral Palsy Using the Mann Assessment of Swallowing Ability.
BACKGROUND
The aim of this study was to evaluate the efficacy of the Mann Assessment of Swallowing Ability (MASA) to predict the results of videofluoroscopic swallowing studies.


METHODS
Children with cerebral palsy with suspicion of aspiration were enrolled. The Functional Dysphagia Scale (FDS) was used to quantify the swallowing dysfunction in videofluoroscopic swallowing studies. Correlation between MASA and FDS scores and differences in these two scores between aspirators and nonaspirators and between silent and overt aspirators were analyzed.


RESULTS
Sixteen patients, level IV or V according the Gross Motor Function Classification System, were included. Thirteen patients (81.3%) had aspiration, and 9 (69.2%) were silent aspirators. The MASA scores between aspirators and nonaspirators were not different (median values of total scores, 107.0 and 94.0). The aspirators had higher FDS pharyngeal subtotal scores (P = 0.024) and slightly higher total FDS scores (P = 0.059). The differences in these two scales between silent and overt aspirators were not significant. Correlation coefficients between oral phase subtotal FDS scores and MASA subtotal scores in oral preparation, oral phase, and oral phase total were -0.713 (P < 0.05), -0.428 (P = 0.098), and -0.665 (P < 0.05), respectively. No correlation was found between the pharyngeal subtotal scores in these two scales.


CONCLUSIONS
MASA was not useful in differentiating aspirators and nonaspirators and between silent and overt aspirators in severely disabled cerebral palsy, but it could predict oral dysfunction in videofluoroscopic swallowing studies.
From the Departments of Physical Medicine & Rehabilitation (C-LS, S-CC, Y-HH, Y-HL) and Urology (S-LC), Chung Shan Medical University Hospital, Taichung; School of Medicine, Chung Shan Medical University, Taichung (C-LS, S-LC, S-CC, Y-HH); Department of Physical Medicine and Rehabilitation, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung (S-WT); Department of Physical Medicine and Rehabilitation, School of Medicine, Tzu Chi University, Hualien (S-WT); and Maria Social Welfare Foundation, Taichung, Taiwan (F-FT).
Chun-Lang
CL
Su
Sung-Lang
SL
Chen
Sen-Wei
SW
Tsai
Fan-Fei
FF
Tseng
Shih-Chung
SC
Chang
Yu-Hui
YH
Huang
Yu-Hao
YH
Lin
D000293:Adolescent; D001466:Barium Sulfate; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D003287:Contrast Media; D003679:Deglutition; D003680:Deglutition Disorders / Q000150:complications / Q000209:etiology*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D053120:Respiratory Aspiration / Q000175:diagnosis* / Q000209:etiology; D012720:Severity of Illness Index; D014741:Video Recording; D055815:Young Adult
D003287:Contrast Media; D001466:Barium Sulfate