Acute characteristics of pediatric Dysphagia subsequent to traumatic brain injury: videofluoroscopic assessment.

OBJECTIVE

To document the acute characteristics of swallowing impairment in a group of children post moderate/severe traumatic brain injury (TBI) by means of videofluoroscopy.

PARTICIPANTS

Eighteen children with moderate/severe TBI.

MAIN OUTCOME MEASURE

Videofluoroscopy at an average of 27.7 days post-injury.

RESULTS

Subjects demonstrated a range of dysphagia severity levels: mild-moderate (n = 8), moderate (n = 6), moderate-severe (n = 3), and severe (n = 1) and had a combination of oral and pharyngeal phase characteristics. More specifically, observable features or physiological impairments that were identified included reduced lingual control, hesitancy of tongue movement, repetitive tongue pumping, the presence of aspiration (including silent aspiration), delayed swallow reflex trigger, reduced laryngeal elevation and closure, and reduced peristalsis.

CONCLUSIONS

These data highlight the diversity of swallowing deficits and dysphagia severity levels in children following TBI and suggest that the former are consistent with a pattern of oropharyngeal impairments.