Neonatal swallowing assessment using fiberoptic endoscopic evaluation of swallowing (FEES).
OBJECTIVES
Swallowing disorders which lead to aspiration are common in premature infants with a postmenstrual age (PMA) of >36 weeks. Aspiration is often silent and the unique symptom is desaturation during feeding. The aim of this study was 1) to determine the number of prematures with desaturations during feeding due to aspiration, using Fiberoptic Endoscopic Evaluation of Swallowing (FEES); 2) to relate clinical factors and FEES findings to aspiration; and 3) to describe type and efficacy of suggested treatments.


METHODS
A retrospective review of 62 ex-premature babies with a median PMA of 40 weeks which underwent FEES due to persistent feeding desaturations. Aspiration was related to other FEES findings and to clinical and demographic data. The efficacy of the treatment was evaluated during the FEES and by comparing recorded desaturations during feeding 7 days before and after FEES.


RESULTS
A total of 44 (71%) infants were diagnosed with aspiration and/or penetration. No relation was found to demographic or clinical data. The accumulation of saliva and residues post-swallowing were related to aspiration (P < 0.01). In 77.3% of the infants, use of a thickener seemed to reduce aspiration during FEES and was suggested as a treatment. 13.6% of infants received anti-reflux treatment after FEES and 9.1% required gastrostomy.


CONCLUSIONS
Aspiration is very frequent in premature infants who present desaturations during feeding and FEES is a useful method for diagnosing and suggesting treatments.
['Vetter-Laracy|Susanne|S|', 'Osona|Borja|B|', 'Roca|Antonia|A|', 'Peña-Zarza|Jose A|JA|', 'Gil|Jose A|JA|', 'Figuerola|Joan|J|']
D003679:Deglutition D003680:Deglutition Disorders D004724:Endoscopy D005260:Female D005764:Gastroesophageal Reflux D005774:Gastrostomy D006801:Humans D007223:Infant D007231:Infant, Newborn D007234:Infant, Premature D008297:Male D015997:Neonatal Screening D055100:Optical Fibers D053120:Respiratory Aspiration D012189:Retrospective Studies D012463:Saliva
fiberoptic endoscopic evaluation of swallowing premature newborn videofluroscopic swallow study