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Aspiration in the otherwise healthy Infant—Is there a natural course for improvement?
Author(s) -
Casazza Geoffrey C.,
Graham M. Elise,
Asfour Fadi,
O'Gorman Molly,
Skirko Jonathan,
Meier Jeremy D.
Publication year - 2020
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27888
Subject(s) - medicine , dysphagia , swallowing , confidence interval , pediatrics , surgery , retrospective cohort study
Objectives/Hypothesis Timing and indication for surgical intervention is a major challenge in managing pediatric oropharyngeal dysphagia. No study has evaluated a natural course of swallowing dysfunction in otherwise healthy infants. Our objective was to review the outcomes and time to resolution of abnormal swallow in infants with aspiration. Study Design Retrospective case series at a tertiary children's hospital. Methods Fifty patients under 1 year old with aspiration on a modified barium swallow study were included. Patients born <34 weeks, with medical or genetic comorbidities, or who underwent surgical intervention for aspiration were excluded. Patients were followed until aspiration resolved on a swallow study. Kaplan‐Meier survival analysis was performed. Results Forty patients (25 patients [50%] by 6 months, 10 [20%] by 1 year, three [6%] by 2 years, and two [4%] at the end of the follow‐up interval) were recommended a normal diet, and 10 patients (20%) were still aspirating by the end of the follow‐up interval. Median time to resolution was 202 ± 7 days (range, 19–842 days), probability 48% (95% confidence interval [CI]: 0.34‐0.62). The probability of resolution at 6 months was 46% (95% CI: 0.4‐0.68), at 1 year was 64% (95% CI: 0.51‐0.77), at 2 years was 76% (95% CI: 0.64‐0.88), and at the end of the follow‐up interval 81.3% (95% CI: 0.7‐0.92). Conclusions The majority of infants with aspiration and without any other major comorbidities improved within 1 year. Future research should be directed toward better understanding swallowing dysfunction in neurologically normal infants. Level of Evidence 4 Laryngoscope , 130:514–520, 2020