All issues > Volume 42(1); 1999

Original Article

J Korean Pediatr Soc. 1999;42(1):60-68. Published online January 15, 1999.

Clinical Manifestations of Dysphagia in Children

So Hee SH Chung¹, Nam Seon NS Beck¹, Munhyang MH Lee¹, Sang Il SI Lee¹, Heung Jae HJ Lee¹, Jung Yun JY Choe², Hyun Suk HS Kim²

¹Department of Pediatrics, College of Medicine, Sung Kyun Kwan University, Samsung Medical Center, Seoul, Korea
²Department of Rehabilitation, College of Medicine, Sung Kyun Kwan University, Samsung Medical Center, Seoul, Korea

Abstract

Purpose
: In children, dysphagia is a common cause of recurrent pneumonia and malnutrition and can be fatal. However, till now no studies were performed concerning the clinical investigation of dysphagia in Korea.
Methods
: In this study we evaluated the clinical manifestations of dysphagia in children with an age range between 1 month and 12 years by reviewing the clinical records, and we classified the dysphagia by videofluoroesophagography.
Results
: The etiologies of dysphagia demonstrated as follows; developmental delay in 7 patients, treacheoesophageal fistula in 2 patients, and ischemic encephalopathy, encephalitis, brain tumor, subepiglottic stenosis, bronchiolitis, and Williams syndrome in 1 patient, respectively. The presenting symptoms of dysphagia revealed as follows; choking in 7(46%) patients, nasal regurgitation in 2(13.3%) patients, hypersensitive gag reflex in 2(13.3%) patients and drooling, foreign body sensation, and feeding refusal in 1 patient, respectively. The complications of dysphagia were malnutrition in 12(80%) patients, which was followed by aspiration pneumonia in 8(53.3%) patients. On videofluoroesophagography, 5 patients showed oral phase dysphagia, Seven and two patients showed pharyngeal and esophageal phase dysphagia, respectively. Two patients presented normal deglutition on videofluoroesophagography. Total of 8 patients required gastrostomy because of recurrent aspiration and poor weight gain. In 7 patients, however, dysphagia improved with rehabilitation therapy only.
Conclusion
: Our data demonstrated that the complications of dysphagia in childhood were not uncommon, and suggested that diagnostic workup including videofluoroesophagography were helpful in classifying the feeding difficulties of these children. Gastrostomy and rehabilitation offered effective therapeutic possibilities.

Keywords :Dysphagia, Videofluoroesophagography, Percutaneous endoscopic gastrostomy