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Diagnosis and management of aspiration using fiberoptic endoscopic evaluation of swallowing in a pediatric pulmonology unit
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  • Fernando Rafael Aguirregomezcorta,
  • Borja Osona,
  • Jose Peña,
  • Jose Antonio Gil,
  • Susanne Vetter-Laracy,
  • Guillem Frontera,
  • Joan Figuerola,
  • Cati Bover-Bauza
Fernando Rafael Aguirregomezcorta
Hospital Universitari Son Espases
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Borja Osona
Hospital Universitario Son Espases
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Jose Peña
Hospital Son Espases
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Jose Antonio Gil
Hospital Universitari Son Espases
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Susanne Vetter-Laracy
Hospital Universitari Son Espases
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Guillem Frontera
Hospital Universitari Son Espases
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Joan Figuerola
Hospital Son Espases
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Cati Bover-Bauza
Hospital Universitari Son Espases
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Abstract

Background and Objectives: Swallowing disorders lead to chronic lung aspiration. Early detection and treatment of aspiration in children with dysphagia is important to prevent lung damage. Diagnosis of aspiration, which may be silent, requires an instrumental study such as fiberoptic endoscopic evaluation of swallowing (FEES). Despite its usefulness, it is rarely practiced by pediatric pulmonologists. This study aimed to evaluate the feasibility and utility of FEES performed in the pediatric respiratory unit of a tertiary hospital, analyze the clinical characteristics, endoscopic findings and proposed treatments, and identify the factors associated with penetration or aspiration. Methods: Medical records of 373 children with suspected aspiration who were referred to the pediatric respiratory unit for FEES were reviewed retrospectively. Clinical characteristics, FEES findings, and the proposed treatments were analyzed. Results: Aspiration was seen in 47.9% of the patients. The most common associated conditions were neurological disease and prematurity. The most frequently observed endoscopic finding was altered laryngeal sensitivity (36.5%). Intervention was recommended in 54.2 % of the patients. Complications were not seen during any of the procedures. Conclusions: The FEES procedure performed by pediatric pulmonologists is a reliable method for diagnosing aspiration in children. It can be safely executed by trained pulmonologists, and significant endoscopic signs other than aspiration can guide in the diagnosis and management recommendations.

Peer review status:ACCEPTED

13 Nov 2020Submitted to Pediatric Pulmonology
17 Nov 2020Submission Checks Completed
17 Nov 2020Assigned to Editor
17 Nov 2020Reviewer(s) Assigned
03 Dec 2020Review(s) Completed, Editorial Evaluation Pending
03 Dec 2020Editorial Decision: Revise Major
27 Jan 20211st Revision Received
28 Jan 2021Assigned to Editor
28 Jan 2021Submission Checks Completed
28 Jan 2021Reviewer(s) Assigned
04 Feb 2021Review(s) Completed, Editorial Evaluation Pending
04 Feb 2021Editorial Decision: Revise Minor
09 Feb 20212nd Revision Received
10 Feb 2021Submission Checks Completed
10 Feb 2021Assigned to Editor
10 Feb 2021Reviewer(s) Assigned
10 Feb 2021Review(s) Completed, Editorial Evaluation Pending
10 Feb 2021Editorial Decision: Accept