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Neurogenic dysphagia

“Paediatric dysphagia” is not related to a specific diagnosis but refers to any disturbance of the normal swallow sequence in infants and children, as difficulties in transporting a bolus from the oral cavity to the back of the tongue or moving food into the oesophagus, compromising safety and adequacy of nutritional intake 6-10[1][2][3][4][5][6].

Dsyphagia resulting from a neurological cause Paediatric swallowing disorders can have several causes, from prematurity and congenital anomalies to gastro-oesophageal reflux and infective or inflammatory pathologies of the upper digestive tract.

In neonates, the swallowing process is reflexive and involuntary. Later in infancy, the oral phase comes under voluntary control, while the pharyngeal phase and oesophageal phases remain involuntary. Swallowing difficulties can severely compromise pulmonary health and nutritional intake of paediatric patients.

Feeding and swallowing are developmental phenomena involving highly complex interactions that begin in embryologic and foetal periods and continue throughout infancy and early childhood[7][8].

. 3

Videofluoroscopic Swallow Study

(VFSS) is a radiographic procedure that provides a dynamic view of the swallowing process and is frequently considered to be definitive evaluation for objective assessment of dysphagia in paediatric patients.

Diagnosis

Children with dysphagia or respiratory problems possibly due to dysphagia, should be seen first by an ear, nose, and throat surgeon or gastroenterologist to exclude structural disorders of the neck, mouth, pharynx, larynx, and oesophagus.

If a structural lesion is excluded and there are no obvious features of neurological disease further enquiry is needed.


1. a Arvedson JC. Feeding with craniofacial anomalies. In: Arvedson JC, Brodsky LB, editors. Pediatric swallowing and feeding: assessment and management. Second edition. Albany, NY: Singular Publishing Group; 2002. pp. 527-61
2. a Miller AJ. The neuroscientific principles of swallowing and dysphagia. San Diego: Singular Publishing Group; 1999. pp. 100-1.
3. a Chantal L. Development of suck and swallow mechanisms in infants. Ann Nutr Metab 2015;66:7-14. https://doi. org/10.1159/000381361.
4. a Groher ME, Crary MA. Dysphagia: clinical management in adults and children. Second edition. Maryland Heights, MO: Mosby/Elsevier; 2010.
6. a Dodrill P, Gosa MM. Pediatric dysphagia: physiology, assessment, and management. Ann Nutr Metab 2015;66(Suppl 5):24-31.https://doi.org/10.1159/000381372.
7. a Stevenson RD, Allaire JH. The development of normal feeding and swallowing. Pediatr Clin North Am 1991;38:1439-53. https://doi. org/10.1016/s0031-3955(16)38229-3
8. a Kahane JC. Postnatal development and aging of the human larynx.Semin Speech Lang 1983; 4:189-203
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