Download PDF
Eur J Pediatr Surg 2017; 27(06): 526-532
DOI: 10.1055/s-0037-1599231
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Effect of Swallowing Rehabilitation Protocol on Swallowing Function in Patients with Esophageal Atresia and/or Tracheoesophageal Fistula

Selen Serel Arslan
1   Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
,
Tutku Soyer
2   Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
,
Numan Demir
1   Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
,
Sule Yalcın
2   Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
,
Ayşe Karaduman
1   Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
,
Ibrahim Karnak
2   Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
,
Feridun Cahit Tanyel
2   Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
› Author Affiliations
Further Information

Publication History

09 November 2016

17 January 2017

Publication Date:
17 March 2017 (online)

    Permissions and Reprints

Abstract

Aim The aim of this study was to evaluate the results of Swallowing Rehabilitation Protocol (SRP) on swallowing function (SF) of esophageal atresia and tracheoesophageal fistula (EA-TEF) patients with pharyngeal swallowing disorder.

Materials and Methods In this study, 24 children with EA-TEF who had deglutitive and respiratory problems were grouped into either study (n = 12) or control group (n = 12) by basic randomization. Study group received the SRP including neuromuscular electrical stimulation, thermal tactile stimulation, and hyolaryngeal mobilization. The control group received nonnutritive stimulations. SF was evaluated with 3 mL liquid and pudding barium by videofluoroscopic swallowing study (VFSS) before and after 20 sessions of interventions.

Results No statistical differences were found between groups in terms of descriptive characteristics including age, sex, weight, height, type of atresia, repair type, repair time, and start time of oral intake (p > 0.05). There were no statistical differences between groups in term of swallowing parameters (p > 0.05), except reflux (p = 0.004) according to VFSS findings. After 20 sessions of interventions, the study group showed improvement in penetration–aspiration scale scores, oral phase dysfunction, delay in swallowing reflex, and residue in valleculae and pyriform sinuses after pudding swallow. The control group showed improvement only in oral phase dysfunction.

Conclusion SRP can be recommended to improve SF in patients with EA/TEF who have pharyngeal swallowing disorders.

Keywords

esophageal atresia - tracheoesophageal fistula - swallowing rehabilitation - deglutition disorders

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.


 

  • References

  • 1 Gupta DK, Sharma S. Esophageal atresia: the total care in a high-risk population. Semin Pediatr Surg 2008; 17 (04) 236-243
    CrossrefPubMedGoogle Scholar
  • 2 Kovesi T, Rubin S. Long-term complications of congenital esophageal atresia and/or tracheoesophageal fistula. Chest 2004; 126 (03) 915-925
    CrossrefPubMedGoogle Scholar
  • 3 Mahoney L, Rosen R. Feeding difficulties in children with esophageal atresia. Paediatr Respir Rev 2016; 19: 21-27
    PubMedGoogle Scholar
  • 4 Yalcin S, Demir N, Serel S, Soyer T, Tanyel FC. The evaluation of deglutition with videofluoroscopy after repair of esophageal atresia and/or tracheoesophageal fistula. J Pediatr Surg 2015; 50 (11) 1823-1827
    CrossrefPubMedGoogle Scholar
  • 5 Coppens CH, van den Engel-Hoek L, Scharbatke H, de Groot SAF, Draaisma JMT. Dysphagia in children with repaired oesophageal atresia. Eur J Pediatr 2016; 175 (09) 1209-1217
    CrossrefPubMedGoogle Scholar
  • 6 Arvedson JC, Lefton-Greif MA. Pediatric Videofluoroscopic Swallow Studies: A Professional Manual with Caregiver Guidelines. San Antonio, TX: Communication Skill Builders; 1998
    Google Scholar
  • 7 Heckathorn DE, Speyer R, Taylor J, Cordier R. Systematic review: non instrumental swallowing and feeding assessments in pediatrics. Dysphagia 2016; 31 (01) 1-23
    CrossrefPubMedGoogle Scholar
  • 8 Conforti A, Valfré L, Falbo M, Bagolan P, Cerchiari A. Feeding and swallowing disorders in esophageal atresia patients: a review of a critical issue. Eur J Pediatr Surg 2015; 25 (04) 318-325
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Carnaby GD, Harenberg L. What is “usual care” in dysphagia rehabilitation: a survey of USA dysphagia practice patterns. Dysphagia 2013; 28 (04) 567-574
    CrossrefPubMedGoogle Scholar
  • 10 Song WJ, Park JH, Lee JH, Kim MY. Effects of neuromuscular electrical stimulation on swallowing functions in children with cerebral palsy: a pilot randomized controlled trial. Hong Kong J Occup Ther 2015; 25: 1-6
    PubMedGoogle Scholar
  • 11 Teismann IK, Steinsträter O, Warnecke T. , et al. Tactile thermal oral stimulation increases the cortical representation of swallowing. BMC Neurosci 2009; 10: 71
    CrossrefPubMedGoogle Scholar
  • 12 Matsuo K, Palmer JB. Anatomy and physiology of feeding and swallowing: normal and abnormal. Phys Med Rehabil Clin N Am 2008; 19 (04) 691-707 , vii
    CrossrefPubMedGoogle Scholar
  • 13 Gross AR, Goldsmith C, Hoving JL. , et al; Cervical Overview Group. Conservative management of mechanical neck disorders: a systematic review. J Rheumatol 2007; 34 (05) 1083-1102
    PubMedGoogle Scholar
  • 14 Gross A, Miller J, D'Sylva J. , et al; COG. Manipulation or mobilisation for neck pain: a Cochrane Review. Man Ther 2010; 15 (04) 315-333
    CrossrefPubMedGoogle Scholar
  • 15 Logemann JA. Evaluation of swallowing disorders. In: Logemann JA. , ed. Evaluation and Treatment of Swallowing Disorders. Austin, TX: Pro ed; 1998: 139-168
    Google Scholar
  • 16 Fuller L, Huprich JE, Theisen J. , et al. Abnormal esophageal body function: radiographic-manometric correlation. Am Surg 1999; 65 (10) 911-914
    PubMedGoogle Scholar
  • 17 Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia 1996; 11 (02) 93-98
    CrossrefPubMedGoogle Scholar
  • 18 Karaduman A, Serel S, Ünlüer Ö, Demir N. The penetration aspiration scale: an interrater reliability study. Turk J Physiother Rehabil 2012; 23: 151-155
    PubMedGoogle Scholar
  • 19 Cartabuke RH, Lopez R, Thota PN. Long-term esophageal and respiratory outcomes in children with esophageal atresia and tracheoesophageal fistula. Gastroenterol Rep (Oxf) 2016; 4 (04) 310-314
    PubMedGoogle Scholar
  • 20 Ramsay M, Birnbaum R. Feeding difficulties in children with esophageal atresia: treatment by a multidisciplinary team. Dis Esophagus 2013; 26 (04) 410-412
    CrossrefPubMedGoogle Scholar
  • 21 DeBoer EM, Prager JD, Ruiz AG. , et al. Multidisciplinary care of children with repaired esophageal atresia and tracheoesophageal fistula. Pediatr Pulmonol 2016; 51 (06) 576-581
    CrossrefPubMedGoogle Scholar