title: Both pharyngeal and esophageal phases of swallowing are associated with recurrent pneumonia in pediatric patients.
abstract: BACKGROUND
  One of the underlying causes of recurrent pneumonia in children is swallowing dysfunction, with aspiration syndrome. Swallowing dysfunction should be considered not only a problem of the oropharyngeal phase but also a problem of the esophageal phase.
  
  
  OBJECTIVE
  This study aimed to determine the relationship between findings from a swallowing study and a history of recurrent pneumonia in pediatric patients.
  
  
  METHODS
  A videofluroscopic swallowing study of 274 pediatric patients who had swallowing dysfunction was conducted. Information on a history of recurrent pneumonia during a 1-year period was obtained from hospital files.
  
  
  RESULTS
  The median age of the participants was 33 months (min =10, max = 180), of whom 51.8% were females. In the study, 83.2% of the patients had cerebral palsy, 7.7% had syndromic symptoms, 3.6% had muscular dystrophy, and 5.5% were classified as "other." During the 1-year period, 67.9% of the participants had a history of recurrent pneumonia history. Furthermore, 66.4% had oral dysfunction, 32.5% had laryngeal penetration, 46.4% had aspiration, 45.3% had abnormal esophageal body function, and 35.8% had reflux symptoms. There was no correlation between oral dysfunction and recurrent pneumonia (P = .902), but there was a positive correlation between recurrent pneumonia and laryngeal penetration (P < .001, r = .26), aspiration (P < .001, r =.49), abnormal esophageal body function (P = .002, r = .18), and reflux (P < .001, r = .22).
  
  
  CONCLUSIONS
  Both pharyngeal swallowing disorders, such as penetration and aspiration, and esophageal disorders and reflux may result in recurrent pneumonia in pediatric patients. Thus, all phases of deglutition should be considered and followed up during swallowing evaluation.
authors.affiliation: Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
authors.forename: Selen
authors.initials: S
authors.lastname: Serel Arslan
authors.affiliation: Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
authors.forename: Numan
authors.initials: N
authors.lastname: Demir
authors.affiliation: Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
authors.forename: Aynur Ayşe
authors.initials: AA
authors.lastname: Karaduman
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000150:complications* / Q000175:diagnosis; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male; D010372:Pediatrics; D010614:Pharynx / Q000503:physiopathology*; D011015:Pneumonia, Aspiration / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014741:Video Recording
keywords: deglutition; pediatrics; pneumonia; swallowing