Osorio Steven, Borbon Maria Camila, Hersh Cheryl, Hartnick Christopher
Otolaryngology Pediatric Airway Surgery, Hospital Infantil Napoleón Franco Pareja, Cartagena, Colombia.
Otolaryngology Department, Hospital Serena del Mar, Cartagena, Colombia.
Dysphagia. 2025 Oct 4. doi: 10.1007/s00455-025-10893-5.
We present the case of a 2-year-old male with persistent oropharyngeal dysphagia and recurrent aspiration. Feeding difficulties began in the neonatal period, characterized by coughing, wet cry, choking, and cyanosis during feeds. Multiple hospitalizations followed, and flexible endoscopic evaluation of swallowing (FEES) showed mobile vocal folds and pharyngeal pooling and silent aspiration with various consistencies, alongside absent swallow initiation. Videofluoroscopic swallowing studies (VFSS) demonstrated ongoing penetration and aspiration, with contrast coating both, anterior and posterior tracheal wall during pharyngeal phase, leading to gastrostomy placement. What mechanisms might explain persistent severe dysphagia in this child, and what therapeutic strategies could be considered?
我们报告了一例2岁男性患儿，患有持续性口咽吞咽困难和反复误吸。喂养困难始于新生儿期，表现为喂奶期间咳嗽、哭声带痰、呛噎和发绀。随后多次住院，灵活内镜吞咽评估（FEES）显示声带活动正常、咽部有液体潴留以及不同黏稠度的无声误吸，同时缺乏吞咽启动动作。电视荧光吞咽造影检查（VFSS）显示存在持续的食物渗入和误吸，在咽部阶段造影剂覆盖气管前壁和后壁，最终导致胃造口术。哪些机制可以解释该患儿持续存在的严重吞咽困难，可考虑采取哪些治疗策略？
