Aspiration status per video-fluoroscopy swallow study
The aspiration status per VFSS, according to demographics, organ system
involvement and medical diagnoses is shown in table 2. Throughout, overt
aspirations were the least frequent finding, compared to no aspiration
and silent aspiration. Out of the 22 infants aged under one year, only
one showed overt aspirations alone on VFSS, whilst 10 (45%) had silent
aspirations. Examining these 10 more closely, only three were suspected
to have silent aspiration according to CFE, five were considered to have
overt aspirations alone and two were thought to have no aspirations.
The silent aspiration group had a high representation of neurological
and genetic abnormalities, and particularly of clinically suspected
aspiration pneumonias. Structural abnormalities were associated with the
lowest rates of aspiration.
Figure 3 shows the various types of aspiration encountered per texture
trialed, as identified by VFSS. Among 113 children, 89 were evaluated
with thin liquid, 70 with thick liquid, 60 with thin puree, 67 with
thick puree and 47 with solids. For all consistencies, “no aspiration”
was the most common, and “overt aspiration” the least common result.
Of note, 25/70 (36%) of subjects had silent aspiration with thick
liquid. The fewest aspirations were noted with solids, with all 5/47
(11%) showing silent aspirations.
A logistic regression model, relating medical diagnoses to the presence
of aspiration (combined overt and silent), according to VFSS is shown in
table 4. It shows that children with clinical aspiration lung disease
and cerebral palsy were more prone to VFSS aspiration, with an OR of 3.2
and 9.8 respectively. These observations hold true following adjustment
for age.