신생아 및 영아기 윤상인두 협조불능의 임상적 고찰
Clinical Features of Cricopharyngeal Incoordination in Newborns and Infants
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Cricopharyngeal incoordination is a rare cause of swallowing difficulties in newborns and infants; it is characterized by delayed pharyngeal contractions related to cricopharyngeal relaxation. Dysphagia and repeated aspiration are common findings despite normal sucking. We conducted this study to assess the clinical features of cricopharyngeal incoordination in newborns and infants. Methods: An analysis of the clinical data from 17 patients with cricopharyngeal incoordination who were admitted to the Department of Pediatrics, Pusan National University Hospital, between 2000 and 2006 was conducted retrospectively. The diagnosis of cricopharyngeal incoordination was established by the clinical characteristics and the videofluoroscopic swallowing studies. Results: The male to female ratio was 1：1.1 (males 8, females 9) the age range 1 to 60 days. The body weight of 11 patients (64.7%) was less than the 10th percentile at diagnosis. Six patients (35.3%) were born prematurely. The associated anomalies or diseases were chromosomal anomaly (2 cases), congenital heart disease (3 cases), and laryngomalacia, hypoxic brain damage or neonatal seizures (1 case each). The chief complaints of patients were recurrent aspiration pneumonia (10 cases), feeding difficulty (9 cases), dyspnea (4 cases), and chocking (4 cases). The severity of aspiration on the videoesophagogram or esophagogram was mild in 12 cases. The correlation between the severity of aspiration and the duration of tube feeding after the diagnosis was significant (p＜0.05). Conclusion: Cricopharyngeal incoordination should be considered in the differential diagnosis of newborns and infants, without known risk factors associated with swallowing dysfunction, when they present with unexplained respiratory problems. Although the prognosis of cricopharyngeal incoordination is good, early diagnosis and tube feeding are recommended to prevent the complications associated with this disorder.
Abstract
Purpose: Cricopharyngeal incoordination is a rare cause of swallowing difficulties in newborns and infants; it is characterized by delayed pharyngeal contractions related to cricopharyngeal relaxation. Dysphagia and repeated aspiration are common findings despite normal sucking. We conducted this study to assess the clinical features of cricopharyngeal incoordination in newborns and infants. Methods: An analysis of the clinical data from 17 patients with cricopharyngeal incoordination who were admitted to the Department of Pediatrics, Pusan National University Hospital, between 2000 and 2006 was conducted retrospectively. The diagnosis of cricopharyngeal incoordination was established by the clinical characteristics and the videofluoroscopic swallowing studies. Results: The male to female ratio was 1：1.1 (males 8, females 9) the age range 1 to 60 days. The body weight of 11 patients (64.7%) was less than the 10th percentile at diagnosis. Six patients (35.3%) were born prematurely. The associated anomalies or diseases were chromosomal anomaly (2 cases), congenital heart disease (3 cases), and laryngomalacia, hypoxic brain damage or neonatal seizures (1 case each). The chief complaints of patients were recurrent aspiration pneumonia (10 cases), feeding difficulty (9 cases), dyspnea (4 cases), and chocking (4 cases). The severity of aspiration on the videoesophagogram or esophagogram was mild in 12 cases. The correlation between the severity of aspiration and the duration of tube feeding after the diagnosis was significant (p＜0.05). Conclusion: Cricopharyngeal incoordination should be considered in the differential diagnosis of newborns and infants, without known risk factors associated with swallowing dysfunction, when they present with unexplained respiratory problems. Although the prognosis of cricopharyngeal incoordination is good, early diagnosis and tube feeding are recommended to prevent the complications associated with this disorder.
참고문헌 (14)
- Dodds WJ, "Physiology and radiology of the normal oral and pharyngeal phases of swallowing", AJR Am J Roentgenol, 154, pp.953~963 (1990)
- Sood MR, "Achalasia and other motor disorders. In: Pediatric gastrointestinal and liver disease", pp.327~338 (2006), Saunders Co
- Frank MM, "Transient pharyngeal incoordination in the newborn", Am J Dis Child, 111, pp.178~181 (1966)
- Kim YJ, "Cricopharyngeal incoordination in infancy", J Korean Pediatr Soc, 37, pp.752~757 (1994)
- Arvedson JC, "Anatomy, physiology, and development of feeding", Semin Speech Lang, 17, pp.261~268 (1996)
- Lisa A, "Hamner A. Swallowing function and medical diagnoses in infants suspected of dysphagia", Pediatrics, 108, pp.106~ (2001)
- Chistiakova VR, "Dysphagia in infants", Vestn Otorinolaringol, 5, pp.19~21 (1996)
- Utian HL, "Cricopharyngeal Incoordination in infancy", Pediatr, 43, pp.402~406 (1969)
- Matsaniotis N, "Difficulty in swallowing, with aspiration pneumonia in infancy", Arch Dis Child, 42, pp.308~310 (1967)
- Roger G, "Garabedian EN. Severe laryngomalacia: surgical indications and results in 115 patients", Laryngoscope, 105, pp.1111~1117 (1995)
- Eicher PS, "Driscoll DA, Emanuel BS, Zackai EH. Dysphagia in children with a 22q11.2 deletion: unusual pattern found on modified barium swallow", J Pediatr, 137, pp.158~164 (2000)
- DeMatteo C, "Comparison of clinical and videofluoroscopic evaluation of children with feeding and swallowing difficulties", Dev Med Child Neurol, 47, pp.149~157 (2005)
- Arvedson J, "Silent aspiration prominent in children with dysphagia", Int J Pediatr Otorhinolaryngol, 28, pp.173~181 (1994)
- Delzell PB, "Laryngeal penetration: a predictor of aspiration in infants?", Pediatr Radiol, 29, pp.762~765 (1999)