Sjögreen Lotta, Gonzalez Lindh Margareta, Brodén Madeleine, Krüssenberg Corinna, Ristic Irvina, Rubensson Agneta, McAllister Anita
1 Mun-H-Center Orofacial Resource Centre for Rare Diseases, Public Dental Service, Gothenburg, Sweden.
2 Department of Speech and Language Pathology, Gävle Hospital, Gävle, Sweden.
Ann Otol Rhinol Laryngol. 2018 Dec;127(12):978-985. doi: 10.1177/0003489418803963. Epub 2018 Oct 8.
: Dysphagia and impaired saliva control are common in children and adolescents with congenital and developmental disabilities. The aim of the present review was to investigate the evidence base for oral sensory-motor interventions in children and adolescents with dysphagia or impaired saliva control secondary to congenital or early-acquired disabilities and to make recommendations regarding methods for intervention.
: A review of the literature from 2000 to 2016, including oral sensory-motor intervention studies for children and adolescents (3-18 years of age) with dysphagia or impaired saliva control secondary to congenital or early-acquired disabilities, was performed. The literature search included the PubMed, CINAHL, Medline, SpeechBITE, OVID, ERIC, Cochrane, and Google Scholar databases. Primary studies were evaluated on a 4-grade scale using the Grading of Recommendations Assessment, Development and Evaluation.
: Twenty primary studies of oral sensory-motor interventions for dysphagia and 6 studies for the treatment of impaired saliva control fulfilled the inclusion criteria. Of these, 3 were randomized, controlled trials. Five systematic reviews and 16 narrative reviews were also included. Limited and moderately strong recommendations were made on the basis of the grading results from the primary studies. The studies reported good results, but study design was often insufficient, and the study groups were small. The systematic reviews confirmed the lack of high scientific support for oral sensory-motor interventions in children and adolescents with congenital and developmental disabilities.
: There is an urgent need for high-quality studies that could serve as the basis for strong recommendations relating to oral sensory-motor interventions for children with dysphagia and impaired saliva control.
吞咽困难和唾液控制障碍在患有先天性和发育性残疾的儿童及青少年中很常见。本综述的目的是调查针对因先天性或早期获得性残疾继发吞咽困难或唾液控制障碍的儿童及青少年进行口腔感觉运动干预的证据基础,并就干预方法提出建议。
对2000年至2016年的文献进行综述,包括针对因先天性或早期获得性残疾继发吞咽困难或唾液控制障碍的儿童及青少年(3至18岁)的口腔感觉运动干预研究。文献检索包括PubMed、CINAHL、Medline、SpeechBITE、OVID、ERIC、Cochrane和谷歌学术数据库。使用推荐分级评估、发展和评价对主要研究进行四级评分。
20项关于吞咽困难口腔感觉运动干预的主要研究和6项关于唾液控制障碍治疗的研究符合纳入标准。其中,3项为随机对照试验。还纳入了5项系统评价和16项叙述性评价。根据主要研究的分级结果给出了有限和中等强度的推荐。研究报告了良好的结果,但研究设计往往不够充分,且研究组规模较小。系统评价证实,对于患有先天性和发育性残疾的儿童及青少年进行口腔感觉运动干预缺乏高水平的科学支持。
迫切需要高质量的研究,为针对吞咽困难和唾液控制障碍儿童的口腔感觉运动干预提供强有力推荐的依据。