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Clinical Manifestations of Dysphagia in Children

Journal of the Korean Pediatric Society 1999;42(1):60-68.
Published online January 15, 1999.
Clinical Manifestations of Dysphagia in Children
So Hee Chung1, Nam Seon Beck1, Munhyang Lee1, Sang Il Lee1, Heung Jae Lee1, Jung Yun Choe2, Hyun Suk Kim2
1Department of Pediatrics, College of Medicine, Sung Kyun Kwan University, Samsung Medical Center, Seoul, Korea
2Department of Rehabilitation, College of Medicine, Sung Kyun Kwan University, Samsung Medical Center, Seoul, Korea
소아 연하 곤란증의 임상상
정소희1, 백남수1, 이문향1, 이상일1, 이흥재1, 최정윤2, 김현숙2
1성균관대학교 의과대학 삼성서울병원 소아과
2성균관대학교 의과대학 삼성서울병원 재활의학과
: In children, dysphagia is a common cause of recurrent pneumonia and malnutrition and can be fatal. However, till now no studies were performed concerning the clinical investigation of dysphagia in Korea.
: In this study we evaluated the clinical manifestations of dysphagia in children with an age range between 1 month and 12 years by reviewing the clinical records, and we classified the dysphagia by videofluoroesophagography.
: The etiologies of dysphagia demonstrated as follows; developmental delay in 7 patients, treacheoesophageal fistula in 2 patients, and ischemic encephalopathy, encephalitis, brain tumor, subepiglottic stenosis, bronchiolitis, and Williams syndrome in 1 patient, respectively. The presenting symptoms of dysphagia revealed as follows; choking in 7(46%) patients, nasal regurgitation in 2(13.3%) patients, hypersensitive gag reflex in 2(13.3%) patients and drooling, foreign body sensation, and feeding refusal in 1 patient, respectively. The complications of dysphagia were malnutrition in 12(80%) patients, which was followed by aspiration pneumonia in 8(53.3%) patients. On videofluoroesophagography, 5 patients showed oral phase dysphagia, Seven and two patients showed pharyngeal and esophageal phase dysphagia, respectively. Two patients presented normal deglutition on videofluoroesophagography. Total of 8 patients required gastrostomy because of recurrent aspiration and poor weight gain. In 7 patients, however, dysphagia improved with rehabilitation therapy only.
: Our data demonstrated that the complications of dysphagia in childhood were not uncommon, and suggested that diagnostic workup including videofluoroesophagography were helpful in classifying the feeding difficulties of these children. Gastrostomy and rehabilitation offered effective therapeutic possibilities.
Key Words: Dysphagia, Videofluoroesophagography, Percutaneous endoscopic gastrostomy

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