title: Accuracy of clinical swallowing evaluation for diagnosis of dysphagia in children with laryngomalacia or glossoptosis.
abstract: To investigate the accuracy of clinical evaluation of swallowing in a sample of children with laryngomalacia or glossoptosis and describe the prevalence of dysphagia in each of these diseases, as well as characterize the swallow response to speech and language therapy interventions.
  
  
  
  Children aged 1 month to 11 years receiving care at the Department of Otolaryngology, Hospital de Clínicas de Porto Alegre, Brazil, were evaluated in a cross-sectional design. Evaluation of swallowing was performed at two time points by two blinded speech-language pathologists, one responsible for clinical evaluation and the other for videofluoroscopic study. The protocols employed were based on the instruments proposed by DeMatteo et al. (DeMatteo C, Matovich D, Hjartarson A. Comparison of clinical and videofluoroscopic evaluation of children with feeding and swallowing difficulties. Dev Med Child Neurol 2005;47:149-157.).
  
  
  
  The study sample consisted of 29 patients: 10 patients with laryngomalacia and 19 patients with glossoptosis. The sensitivity of clinical evaluation did not exceed 50% in any of the evaluations, but specificity reached 100% in some cases, using thickened liquids. The prevalence of dysphagia was 100%, and the use of thickened liquids significantly reduced tracheal aspiration.
  
  
  
  Dysphagia was highly prevalent in this sample. The sensitivity of clinical evaluation to detect laryngeal penetration and tracheal aspiration was low, as the majority of aspiration events were silent. The videofluoroscopic study is important in order to determine a safest method to feed the patient. Pediatr Pulmonol. 2017;52:41-47. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcellos, 2400, Porto Alegre 90035-003, RS, Brazil.
authors.forename: Marisa
authors.initials: M
authors.lastname: Gasparin
authors.affiliation: Laryngology Unit, Department of Otolaryngology, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, School of Medicine, UFRGS, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
authors.forename: Cláudia
authors.initials: C
authors.lastname: Schweiger
authors.affiliation: Laryngology Unit, Department of Otolaryngology, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, School of Medicine, UFRGS, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
authors.forename: Denise
authors.initials: D
authors.lastname: Manica
authors.affiliation: Department of Radiology, HCPA, Universidade Federal do Rio de Janeiro (UFRJ), Porto Alegre, RS, Brazil.
authors.forename: Antônio Carlos
authors.initials: AC
authors.lastname: Maciel
authors.affiliation: Department of Otolaryngology, HCPA, Porto Alegre, RS, Brazil.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Kuhl
authors.affiliation: School of Speech-Language Pathology and Audiology, UFRGS, Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Deborah Salle
authors.initials: DS
authors.lastname: Levy
authors.affiliation: Pediatric Pulmonology Unit, Department of Pediatrics, HCPA, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, School of Medicine, UFRGS, Porto Alegre, RS, Brazil.
authors.forename: Paulo José Cauduro
authors.initials: PJ
authors.lastname: Marostica
mesh_terms: D001938:Brazil; D003430:Cross-Sectional Studies; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D065710:Glossoptosis / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D055092:Laryngomalacia / Q000150:complications* / Q000503:physiopathology; D008297:Male; D012680:Sensitivity and Specificity
keywords: accuracy; sensitivity; specificity; swallowing disorders; upper airway obstruction