Division of Pediatric Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, U.S.A.
Primary Children's Hospital, Salt Lake City, Utah, U.S.A.
Laryngoscope. 2020 Feb;130(2):514-520. doi: 10.1002/lary.27888. Epub 2019 Mar 5.
OBJECTIVES/HYPOTHESIS: Timing and indication for surgical intervention is a major challenge in managing pediatric oropharyngeal dysphagia. No study has evaluated a natural course of swallowing dysfunction in otherwise healthy infants. Our objective was to review the outcomes and time to resolution of abnormal swallow in infants with aspiration.
Retrospective case series at a tertiary children's hospital.
Fifty patients under 1 year old with aspiration on a modified barium swallow study were included. Patients born <34 weeks, with medical or genetic comorbidities, or who underwent surgical intervention for aspiration were excluded. Patients were followed until aspiration resolved on a swallow study. Kaplan-Meier survival analysis was performed.
Forty patients (25 patients [50%] by 6 months, 10 [20%] by 1 year, three [6%] by 2 years, and two [4%] at the end of the follow-up interval) were recommended a normal diet, and 10 patients (20%) were still aspirating by the end of the follow-up interval. Median time to resolution was 202 ± 7 days (range, 19-842 days), probability 48% (95% confidence interval [CI]: 0.34-0.62). The probability of resolution at 6 months was 46% (95% CI: 0.4-0.68), at 1 year was 64% (95% CI: 0.51-0.77), at 2 years was 76% (95% CI: 0.64-0.88), and at the end of the follow-up interval 81.3% (95% CI: 0.7-0.92).
The majority of infants with aspiration and without any other major comorbidities improved within 1 year. Future research should be directed toward better understanding swallowing dysfunction in neurologically normal infants.
4 Laryngoscope, 130:514-520, 2020.
目的/假设：在儿童口咽吞咽障碍的治疗中，手术干预的时机和适应证是一个主要挑战。目前尚无研究评估其他方面健康的婴儿吞咽功能障碍的自然病程。我们的目的是回顾有吸入史的婴儿吞咽异常的结局和恢复正常吞咽的时间。
在一家三级儿童医院进行的回顾性病例系列研究。
本研究纳入了 50 名在改良钡吞咽研究中存在吸入的 1 岁以下患者。排除了胎龄<34 周、存在医学或遗传合并症或因吸入而行手术干预的患者。患者在吞咽研究显示吸入消失后进行随访。采用 Kaplan-Meier 生存分析。
40 名患者（25 名[50%]在 6 个月时、10 名[20%]在 1 岁时、3 名[6%]在 2 岁时、2 名[4%]在随访结束时）被推荐给予正常饮食，10 名患者（20%）在随访结束时仍有吸入。中位恢复时间为 202±7 天（范围，19-842 天），48%的概率（95%置信区间[CI]：0.34-0.62）。6 个月时的缓解概率为 46%（95% CI：0.4-0.68），1 岁时为 64%（95% CI：0.51-0.77），2 岁时为 76%（95% CI：0.64-0.88），随访结束时为 81.3%（95% CI：0.7-0.92）。
大多数有吸入但无其他主要合并症的婴儿在 1 年内得到改善。未来的研究应致力于更好地了解神经正常婴儿的吞咽功能障碍。
4 Laryngoscope，130：514-520，2020 年。
