Factors associated with oropharyngeal dysphagia diagnosed by videofluoroscopy in children with cerebral palsy

• Published in: Revista de Gastroenterología de México (English Edition) Vol. 87; no. 1; pp. 44 - 51
• Main Authors: González-Rozo, N., Pérez-Molina, J.J., Quiñones-Pacheco, Y.B., Flores-Fong, L.E., Rea-Rosas, A., Cabrales-deAnda, J.L.
• Format: Journal Article
• Language: English
• Published: Mexico Masson Doyma México S.A 01.01.2022; Elsevier
• Subjects: Alimentación; Case-Control Studies; Cerebral Palsy; Child; Cross-Sectional Studies; Deglutition disorders; Deglutition Disorders - etiology; Disfagia; Dysphagia; Feeding; Humans; Nutritional Status; Parálisis cerebral; Trastornos de la deglución; Disfagia; Cerebral palsy; Alimentación; Trastornos de la deglución; Parálisis cerebral; Dysphagia; Deglutition disorders; Feeding
• ISSN: 2255-534X; 2255-534X
• DOI: 10.1016/j.rgmxen.2020.09.004

Oropharyngeal dysphagia (OD) occurs in children with cerebral palsy. It is important to investigate its relationship with some variables, and the objective of this study was to identify factors associated with OD. Case-control study in patients with cerebral palsy from 8months to 15years of age, from November 2018 to November 2019, approved by the Ethics Committee. The diagnosis of OD was made by videofluoroscopy when there was nasopharyngeal reflux, stagnation in the vallecular sinuses, in the piriformis sinuses, penetration, and aspiration. The independent variables were type of cerebral palsy, gross motor impairment classified into five levels, nutritional status and comorbidities. One case with OD was included and the next one without alterations in videofluoroscopy was control. The variables were compared with Chi square and Student's t. The association was measured with odds ratio. The confidence interval was 95%. Thirty patients with OD and 30without OD were studied. Sex, age, birth weight, and gestational age had a similar distribution in the two groups. From the data perceived by the mothers at the time of feeding, the greater frequency of the difficulty in the transfer of the food bolus in the group with OD showed a statistically significant difference (P<.001) and of the studied factors, the levelV of the gross motor involvement was associated with a higher frequency of OD. OD was associated with level V of gross motor involvement. La dysphagia (OD) occurs in children with cerebral palsy. It is important to investigate its relationship with some variables, and the objective of this study was to identify factors associated with OD. Estudio de casos y controles en pacientes con parálisis cerebral de 8meses a 15años de edad, de noviembre de 2018 a noviembre de 2019, aprobado por el Comité de Ética. El diagnóstico de DOF se realizó por videofluoroscopia cuando hubo reflujo nasofaríngeo, estancamiento en valécula, en senos piriformes, penetración y aspiración. Las variables independientes fueron tipo de parálisis cerebral, afectación motora gruesa clasificada en cinco niveles, estado nutricional y comorbilidades. Se incluyó un caso con DOF, y el siguiente sin alteraciones en la videofluoroscopia fue control. Las variables se compararon con chi cuadrado (χ2) y t de Student. La asociación se midió con odds ratio. El intervalo de confianza fue del 95%. Se estudiaron 30 pacientes con DOF y 30 sin DOF. El sexo, la edad, el peso al nacer y la edad gestacional tuvieron distribución similar en los dos grupos. De los datos percibidos por las madres al momento de la alimentación, la mayor frecuencia de la dificultad en el traslado del bolo alimenticio en el grupo con DOF mostró diferencia estadística significativa (p<0.001); de los factores estudiados, el nivelV de la afectación motora gruesa se asoció con mayor frecuencia de DOF (OR: 5.7; IC95%: 1.8–17.5). La DOF se asoció con el nivelV de afectación motora gruesa.