흡인 증상을 호소하는 영아의 비디오연하투시검사 소견
Videofluoroscopic Findings in Infants with Aspiration Symptom
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초록
Objective: To describe the findings of videofluoroscopic study (VFSS) and investigate the usefulness of VFSS as a predictor of aspiration pneumonia in infants with aspiration symptoms. Method: Thirty-eight infants with aspiration symptoms were divided into two groups: those who showed aspiration symptom but had no pneumonia (Aspiration group); those with episode of aspiration pneumonia (Pneumonia group). The subjects’ medical records and the results of VFSS were reviewed. Results: In aspiration group, oral phase was normal and the abnormalities were found only in pharygeal phase in a small number of subjects. On the other hand, pneumonia groups showed poor lip closure and bolus formation in oral phase. Abnormalities of pharyngeal phase were reduced laryngeal elevation, coating of pharyngeal wall, increased residue of valleculae, and delay of pharyngeal transit time. Penetration and aspiration were more frequently observed (p＜0.05). Aspiration pneumonia occurred more frequently among infants who had supraglottic penetration (p＜0.05). Conclusion: Mild abnormalities were found only in pharyngeal phase in aspiration group, whereas VFSS abnormalities were observed in both oral and pharyngeal phase in infants with pneumonia. Our results suggest that VFSS would be useful in predicting the development of pneumonia in infants with aspiration symptoms.
Abstract
Objective: To describe the findings of videofluoroscopic study (VFSS) and investigate the usefulness of VFSS as a predictor of aspiration pneumonia in infants with aspiration symptoms. Method: Thirty-eight infants with aspiration symptoms were divided into two groups: those who showed aspiration symptom but had no pneumonia (Aspiration group); those with episode of aspiration pneumonia (Pneumonia group). The subjects’ medical records and the results of VFSS were reviewed. Results: In aspiration group, oral phase was normal and the abnormalities were found only in pharygeal phase in a small number of subjects. On the other hand, pneumonia groups showed poor lip closure and bolus formation in oral phase. Abnormalities of pharyngeal phase were reduced laryngeal elevation, coating of pharyngeal wall, increased residue of valleculae, and delay of pharyngeal transit time. Penetration and aspiration were more frequently observed (p＜0.05). Aspiration pneumonia occurred more frequently among infants who had supraglottic penetration (p＜0.05). Conclusion: Mild abnormalities were found only in pharyngeal phase in aspiration group, whereas VFSS abnormalities were observed in both oral and pharyngeal phase in infants with pneumonia. Our results suggest that VFSS would be useful in predicting the development of pneumonia in infants with aspiration symptoms.
참고문헌 (15)
- Sectish TC, "Pneumonia. in: Nelson textbook of pediatrics, 18th ed", pp.1795~1799 (2007), Sauders
- Lodha R, "Recurrent pneumonia in children: clinical profile and underlying causes", Acta Paediatr, 91, pp.1170~1173 (2002)
- Vaughan D, "Chronic and recurrent pneumonias in children", Semin Respir Infect, 17, pp.72~84 (2002)
- Owayed AF, "Underlying causes of recurrent pneumonia in children", Arch Pediatr Adolesc Med, 154, pp.190~194 (2000)
- Martin BJ, "The association of swallowing dysfunction and aspiration pneumonia", Dysphagia, 9, pp.1~6 (1994)
- Taniguchi MH, "Assessment of risk factors for pneumonia in dysphagic children: significance of videofluoroscopic swallowing evaluation", Dev Med Child Neurol, 36, pp.495~502 (1994)
- Lefton-Greif MA, "Long-term follow up of oropharyngeal dysphagia in children without apparent risk factors", Pediatr Pulmonol, 41, pp.1040~1048 (2006)
- WHO, "IMCI referral guide: management of the child with a serious infection or severe malnutrition", pp.29~33 (2000), World Health Organization
- Logemann JA, "Manual for the videofluorographic study of swallowing, 2nd ed", pp.18~19 (1998), Pro-ed
- Han TR, "The functional dysphagia scale using videofluoroscopic swallowing study in stroke patients", J Korean Acad Rehab Med, 23, pp.1118~1126 (1999)
- Miller MJ, "Relationship between respiratory control and feeding in the developing infant", Semin Neonatol, 9, pp.221~227 (2004)
- Weir K, "Oropharyngeal aspiration and pneumonia in children", Pediatr Pulmonol, 42, pp.1024~1031 (2007)
- Pikus L, "Videofluoroscopic studies of swallowing dysfunction and the relative risk of pneumonia", AJR, 180, pp.1613~1616 (2003)
- Sheikh S, "Chronic aspiration without gastroesophageal reflux as a cause of chronic respiratory symptoms in neurologically normal infants", Chest, 120, pp.1190~1195 (2001)
- Morton R, "Aspiration with dysphagia: the interaction between oropharyngeal and respiratory impairments", Dysphagia, 17, pp.192~196 (2002)