Otolaryngology and Speech and Language Pathology Evaluation in the Assessment of Oropharyngeal Dysphagia in the Pediatric Population: The Proposal of a Combined Protocol
Introduction: The mechanical and neurogenic dysphagia are debilitating, resulting in malnutrition and chronic lung problems arising from tracheal aspiration and repeated hospitalizations in infants and children.
Objectives: The aim of this study is to propose a protocol in team functional assessment of swallowing in childhood.
Methods: Protocol set with the Otolaryngology and Speech and Language Pathology, with identification of data, historical and clinical parameters of the sensorimotor system and orofacial functions, structural and functional parameters of the pharyngolaryngeal system assessed by fiberopticendoscopic evaluation of swallowing.
Results: Clinical manifestations of swallowing disorders are not specific to etiology, despite complaints and common features are observed, such as vomiting, poor feeding, irritability, fatigue during feeding, drooling, nasal regurgitation, gagging, choking, cyanosis, cough during feeding, altered voice quality, and weight loss. The proposed protocol consists of data of birth, complications, respiratory ventilation, medical and surgical treatments, lung health, presence of stridor, medications, weight history, and oral and enteral nutrition. Clinical data and specifically neurodevelopment assessment of sucking, chewing, and swallowing with the usual utensils for the child and with different consistencies are described. The structural and functional data of the pharyngolaryngeal system are described, as well as signs of pharyngolaryngeal reflux, salivary stasis, laryngotracheal aspiration, early leak, penetration, and/or aspiration, residue after swallowing, coughing, choking, dyspnea and cervical auscultation, swallowing maneuvers, and number of swallows in different consistencies.
Conclusion: The severity of dysphagia and the therapeutic process were possible to be defined by a combined protocol for structural and functional assessment of the child swallowing.