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Author: Isuru Dharmarathna
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
Swallowing, as one of the critical life-skills for newborn infants and brain-developing children, is one of the most complex physiological mechanisms involving the upper aerodigestive system. Due to increased survival rates of infants with complex medical etiologies, prematurity, and severe disabilities, the prevalence of infants and children diagnosed with swallowing disorders is rising. Videofluoroscopic study of swallowing (VFSS) provides visualization of oral, pharyngeal, and esophageal phases of swallowing, as well as airway during swallowing. It is one of the most common instrumental swallowing assessment tools. However, the current practice of pediatric VFSS is non-standardized and subjective, both in choice of the administration protocol and in the assessment of recorded images, resulting in limited reliability and credibility. Given that VFSS entails radiation exposure and is an expensive instrumental assessment, we believe it should be optimized to obtain maximal clinically significant information on swallowing biomechanics in children. In this thesis, we obtained objective quantitative VFSS measures in a large cohort of children from 0-21 years (n=553). Our aims were to (1) study the potential of these measures to determine the risk of swallow impairments in children such as penetration-aspiration and post-swallow residue, (2) provide clinicians with threshold scores/ reference values of objective quantitative swallow measures to identify children at risk of swallowing impairments and (3) develop a standard protocol of objective quantitative swallow measures for children, which will aid objective VFSS interpretation in children. We identified vital measures including bolus clearance ratio (BCR), pharyngeal constriction ratio (PCR), total pharyngeal transit time (TPT), coordination of airway closure with bolus transit (BP1AEcl), maximum opening of PES during a swallow (PESmax) and duration to maximum hyoid elevation (Hdur) to describe swallow biomechanics with satisfactory rater-reliability. The protocol for objective interpretation of pediatric VFSS will aid clinicians in describing swallow biomechanics in children. Further, the threshold scores can be used to identify children at risk that will require closer observation and potential intervention before sequelae of swallow impairments are seen. Through utilizing VFSS to its full potential, meaningful comparison of swallowing skills over time and treatment effects can be made and will lead to clinicians offering more individualized treatment for children with swallowing disorders.
Author: Isuru Dharmarathna
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
Swallowing, as one of the critical life-skills for newborn infants and brain-developing children, is one of the most complex physiological mechanisms involving the upper aerodigestive system. Due to increased survival rates of infants with complex medical etiologies, prematurity, and severe disabilities, the prevalence of infants and children diagnosed with swallowing disorders is rising. Videofluoroscopic study of swallowing (VFSS) provides visualization of oral, pharyngeal, and esophageal phases of swallowing, as well as airway during swallowing. It is one of the most common instrumental swallowing assessment tools. However, the current practice of pediatric VFSS is non-standardized and subjective, both in choice of the administration protocol and in the assessment of recorded images, resulting in limited reliability and credibility. Given that VFSS entails radiation exposure and is an expensive instrumental assessment, we believe it should be optimized to obtain maximal clinically significant information on swallowing biomechanics in children. In this thesis, we obtained objective quantitative VFSS measures in a large cohort of children from 0-21 years (n=553). Our aims were to (1) study the potential of these measures to determine the risk of swallow impairments in children such as penetration-aspiration and post-swallow residue, (2) provide clinicians with threshold scores/ reference values of objective quantitative swallow measures to identify children at risk of swallowing impairments and (3) develop a standard protocol of objective quantitative swallow measures for children, which will aid objective VFSS interpretation in children. We identified vital measures including bolus clearance ratio (BCR), pharyngeal constriction ratio (PCR), total pharyngeal transit time (TPT), coordination of airway closure with bolus transit (BP1AEcl), maximum opening of PES during a swallow (PESmax) and duration to maximum hyoid elevation (Hdur) to describe swallow biomechanics with satisfactory rater-reliability. The protocol for objective interpretation of pediatric VFSS will aid clinicians in describing swallow biomechanics in children. Further, the threshold scores can be used to identify children at risk that will require closer observation and potential intervention before sequelae of swallow impairments are seen. Through utilizing VFSS to its full potential, meaningful comparison of swallowing skills over time and treatment effects can be made and will lead to clinicians offering more individualized treatment for children with swallowing disorders.
Author: Amanda Kate Henderson
Publisher:
ISBN:
Category : Deglutition disorders in children
Languages : en
Pages : 136
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Book Description
Background: Reproducible quantitative swallowing data in children is scarce and could aid clinical decision making. The present study investigated the feasibility of utilising objective measures of timing and displacement in children undergoing a videofluoroscopic swallowing study (VFSS). Methods: One hundred and thirty-three children (mean age 36 mth, range 9 d–21 y, SD 4 y) consecutively referred for a VFSS over 12 months were recruited. Children presented with varying causes of dysphagia: 38% neurological, 26% structural 20% unknown, 10% respiratory, 4% cardiac and 3% other. All children received a standardised protocol including a mid-feed 20-second loop recorded at 25 frames per second. All videos were analysed using objective digital measures of timing and displacement previously described by Leonard and Kendall (1997). Results: Mean radiation time was 1.58 minutes (range 0.15–3.47, SD .66) and mean radiation dose was 30.16 cGycm2 (range 6.5–85 SD, 15.17). Radiation dose (p = .21) and radiation time (p = .72) were not significantly different using the increased frame rate compared with an age-matched cohort (N:133) prior to protocol change. Thirty-five per cent of children aspirated. Younger children were significantly more likely to silently aspirate than older children (p
Author: Gwenda Lake
Publisher:
ISBN:
Category : Deglutition disorders
Languages : en
Pages : 105
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Book Description
Background: Quantitative objective measures are available for use in adult videofluoroscopic swallowing study (VFSS) analysis but are yet to be used routinely in clinical settings. The present study describes the introduction of quantitative objective measures to one regional hospital and investigated the impact implementation of objective measurements in VFSS had on diagnosis and recommendations. Methods: One hundred adults (mean 72.3 years, range 34-93, SD 13.7) consecutively referred for a VFSS over 13 months were recruited. Adults presented with varying likely contributors to their dysphagia: 21% nil diagnosis, 17% stroke, 13% gastroenterology, 12% other neurology, 10% respiratory, 8% head and neck cancer, 8% other otorhinolaryngology (ORL), 6% other and 5% cardiology. All adults received a standardised VFSS protocol (1ml, 3ml, 20ml, 100ml liquid barium plus 5ml barium paste) at 30 frames per second. All VFSS were analysed quantitatively using timing and displacement measures developed by Leonard and Kendall (1997) by an independent rater. All VFSS were also analysed separately using a traditional observational approach by a different rater. Both independent raters were provided with age, gender and primary aetiology but no further clinical information. Both independent rater reports were then compared to the reports completed by the patient's treating speech-language therapist (SLT). Ten percent of VFSS were objectively reanalysed to check intra-rater reliability. Ten percent of VFSS were double-blind rated by a year two masters student to check inter-rater reliability. Results: Identification of impairments in pharyngeal constriction, hyoid maximum displacement and pharyngoesophageal segment maximum opening achieved only slight to moderate inter-rater reliability across raters (Kappa (K)=0-0.457). In comparison, intra-rater and inter-rater reliability between objective raters achieved excellent agreement (K=0.767-0.998, 0.773-0.926 respectively). Incidence of impairment across both displacement and timing measures were lower in treating SLTs compared with objective independent raters (p
Author: Joan C. Arvedson
Publisher: Plural Publishing
ISBN: 1944883525
Category : Medical
Languages : en
Pages : 619
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Book Description
Pediatric Swallowing and Feeding: Assessment and Management, Third Edition provides information to practitioners interested in and involved with children who demonstrate swallowing and feeding disorders. Since the 2002 publication of the second edition, there has been an exponential increase in the number of medically fragile and complex children with swallowing/feeding disorders. A corresponding proliferation in the related basic and clinical research has resulted in the increased appreciation of the complicated inter-relationships between structures and systems that contribute to swallowing/feeding development, function, and disorders. Case studies throughout the book provide examples for decision making and highlight salient points. New to the Third Edition: * Maureen A. Lefton-Greif, PhD, CCC-SLP, BCS-S, is welcomed as co-editor. She brings extensive research expertise and clinical practice in pediatric dysphagia and feeding. * All chapters contain significant updated evidence-based research and clinical information. * New chapters focus on the genetic testing and conditions associated with swallowing and feeding disorders, and the pulmonary manifestations and management of aspiration. * World Health Organization (WHO) description of an International Classification of Functioning, Disability, and Health (ICF) sets the stage for an in-depth discussion of clinical feeding evaluation procedures, interpretation, and management decision making. Pediatric Swallowing and Feeding continues to be the leading text on pediatric dysphagia that provides practical information for clinicians seeing children with swallowing and feeding disorders. The overall importance of an appropriate fund of knowledge and shared experience employing team approaches is emphasized throughout this third edition as in the earlier editions of this book. From the Foreword: "The Editors have recognized the advances and changes in the understanding in the information now available for the care of pediatric swallowing and feeding challenges. They have recruited an outstanding group of contributors for this newest edition. There are numerous critically important updates and additions in the third edition. They have included World Health Organizations International Classification of Functioning, Disability and Health is the functional basis in all areas of the book. This text has its importance as there has been an increased number of children with complex medical and healthcare conditions which are risk for feeding and swallowing disorders. This edition stresses the need for team approaches and also documents the use of “virtual” teams ...Pediatric Swallowing and Feeding: Assessment and Management, Third Edition is the fundamental holistic source for all healthcare providers providing the care for swallowing and feeding in children. This book will be utilized by all caring for children with feeding and swallowing problems throughout the world. The previous editions have been and now this updated third edition continues to be the standard source for the information concerning diagnosis and care of these children." —Robert J. Ruben, MD, FAAP, FACS Distinguished University Professor Departments of Otorhinolaryngology – Head and Neck Surgery and Pediatrics Albert Einstein College of Medicine Montefiore Medical Center Bronx, New York
Author:
Publisher:
ISBN: 9781597561532
Category : Deglutition disorders
Languages : en
Pages : 345
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Book Description
Author: Tobias Warnecke
Publisher: Springer Nature
ISBN: 3030421406
Category : Medical
Languages : en
Pages : 416
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Book Description
This book is a clinical manual that covers the whole spectrum of swallowing and its disorders. It starts with physiology of swallowing, pathophysiology of disordered deglutition, diagnostic methods (clinical and instrumental) and ends with an in-depth’s and up-to-date presentation of current treatment options. The clinically most relevant topics of dysphagia management on the stroke unit and the intensive care unit are dealt with in separate chapters. Also the closely intertwined issue of nutritional management is specifically addressed. Most importantly, the book covers all obligatory topics of the Flexible Endoscopic Evaluation of Swallowing (FEES)-curriculum, an educational initiative that started in Germany in 2014 and is currently being extended to other European and non-European countries. The book is richly illustrated and an online video section provides a number of typical patient cases. FEES is probably the most commonly chosen method for the objective assessment of swallowing and its disorders. It is used in stroke units, intensive care facilities, geriatric wards but also in rehabilitation clinics and within dedicated outpatient services. This book on neurogenic dysphagia therefore addresses a wide range of different medical disciplines, such as neurologists, geriatricians, intensive care physicians, rehabilitation physicians, gastroenterologists, otolaryngologists, phoniatrists and also speech-language pathologists.
Author: Michael E. Groher
Publisher: Elsevier Health Sciences
ISBN: 0323187021
Category : Medical
Languages : en
Pages : 352
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Book Description
Develop the understanding and clinical reasoning skills you’ll need to confidently manage dysphagia in professional practice! This logically organized, evidence-based resource reflects the latest advancements in dysphagia in an approachable, student-friendly manner to help you master the clinical evaluation and diagnostic decision-making processes. Realistic case scenarios, detailed review questions, and up-to-date coverage of current testing procedures and issues in pediatric development prepare you for the conditions you’ll face in the clinical setting and provide an unparalleled foundation for professional success. Comprehensive coverage addresses the full spectrum of dysphagia to strengthen your clinical evaluation and diagnostic decision-making skills. Logical, user-friendly organization incorporates chapter outlines, learning objectives, case histories, and chapter summaries to reinforce understanding and create a more efficient learning experience. Clinically relevant case examples and critical thinking questions throughout the text help you prepare for the clinical setting and strengthen your decision-making skills. Companion Evolve Resources website clarifies key diagnostic procedures with detailed video clips.
Author: Joan C. Arvedson
Publisher: Academic Press
ISBN: 9780127850641
Category :
Languages : en
Pages : 0
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Book Description
Pediatric Videofluoroscopic Swallow Studies will become a standard reference for health care and educational professionals involved in the care of infants and children with feeding and swallowing problems. The VFSS, although one component of a comprehensive feeding and swallowing evaluation, is the gold standard for instrumental assessment. This manual is the first in-depth description of this specialized study that focuses directly on pediatric patients with dysphagia.
Author: Bonnie Martin-Harris
Publisher:
ISBN: 9781935578314
Category :
Languages : en
Pages : 78
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Book Description
Author: Steven B. Leder
Publisher: Springer
ISBN: 331905113X
Category : Medical
Languages : en
Pages : 164
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Book Description
The Yale Swallow Protocol is an evidence-based protocol that is the only screening instrument that both identifies aspiration risk and, when passed, is able to recommend specific oral diets without the need for further instrumental dysphagia testing. Based upon research by Drs. Steven B. Leder and Debra M. Suiter, an easily administered, reliable and validated swallow screening protocol was developed and can be used by speech-language pathologists, nurses, otolaryngologists, oncologists, neurologists, intensivists and physicians assistants. In addition, the protocol can be used in a variety of environments, including acute care, rehabilitation and nursing homes. The Yale Swallow Protocol meets all of the criteria necessary for a successful screening test, including being simple to administer, cross-disciplinary, cost effective, acceptable to patients and able to identify the target attribute by giving a positive finding when aspiration risk is present and a negative finding when aspiration risk is absent. Additionally, early and accurate identification of aspiration risk can significantly reduce health-care costs associated with recognized prandial aspiration.
