Static endoscopic swallow evaluation in children. The Laryngoscope Meister, K. D., Okland, T., Johnson, A., Galera, R., Ayoub, N., Sidell, D. R. 2019

Abstract

OBJECTIVES: Static Endoscopic Evaluation of Swallowing (SEES) has been demonstrated to have a strong correlation with the Videofluoroscopic Swallow Study (VFSS) in adults. In children, Fiberoptic Endoscopic Evaluations of Swallow (FEES) are frequently performed to avoid repeated VFSS; however, a subset of the population does not tolerate FEES. The purpose of this study was to evaluate the utility of a modified SEES in children.METHODS: Charts of 50 consecutive patients who underwent FEES evaluations were reviewed. Patients age 3 months to 12years undergoing SEES, FEES, and VFSS were extracted. We compared a binary assessment of outcome on SEES versus VFSS as the diagnostic standard to report characteristics, including sensitivity, specificity, and positive and negative predicted value.RESULTS: A total of 36 patients met all inclusion criteria (mean age 2.8years). Using the VFSS as the diagnostic standard, residue seen on SEES had a sensitivity of 80.0%, specificity of 85.7%, a positive predictive value of 88.9%, and a negative predictive value of 75.0% for predicting deep penetration or aspiration.CONCLUSION: SEES may be helpful for developing an initial diagnostic impression and may serve as a platform for patient and caregiver counseling. In children who are unable to cooperate with FEES, SEES may provide clinical insight in predicting an abnormal swallow study; however, a normal SEES was less reliable in predicting a safe swallow on subsequent VFSS in this patient population.LEVEL OF EVIDENCE: 4 Laryngoscope, 2019.

View details for DOI 10.1002/lary.28263

View details for PubMedID 31448817