Multidisciplinary Management of Pediatric Dysphagia: Solving the Swallow! (2023 AMW)
2023 AAO-HNSF Annual Meeting & OTO Experience
This multidisciplinary panel addresses pediatric dysphagia - an AAO-HNS targeted knowledge gap - and is comprised of pediatric otolaryngologists, a speech and language pathologist and a gastroenterologist, who specialize in treating pediatric dysphagia at a tertiary, free-standing children’s hospital. The panelists are members of an active multidisciplinary aerodigestive team in existence for >10 years. Case reports and videos illustrate the types of pediatric dysphagia, common diagnostic tests and management strategies. Pediatric dysphagia can be isolated but often occurs with comorbid conditions and is best addressed by a multidisciplinary approach. Pediatric dysphagia is classified as oral, pharyngeal, (including aspiration/penetration), oropharyngeal (oral AND pharyngeal) and esophageal. Sensory, motor, anatomic, behavioral, and developmental etiologies are often identified. Common diagnostic tools of pediatric dysphagia include a clinical evaluation of swallow, flexible endoscopic evaluation of swallow (FEES), endoscopy and video fluoroscopic swallow study (modified barium swallow). Based on study results, a comprehensive feeding plan is created for the child to allow for safe nutritional intake and progression toward developmentally appropriate oral motor skills. We will also discuss key aspects of the physical exam in an infant. Use of compensatory strategies including thickened liquids, modified feeding equipment, feeding strategies and caregiver training will be illustrated. Surgical treatment of anatomic causes including post cricoid vascular cushion, type 2 laryngeal cleft, vocal cord dysfunction and cricopharyngeal achalasia will be presented. The clinical utility of the 7 point Functional Oral Intake Scale (FOIS) will be reviewed to facilitate the practitioner’s analysis of patient outcomes. With thoughtful consideration, most pediatric patients with dysphagia can continue some form of oral alimentation for improved quality of life. Attend this panel to broaden your knowledge of this fascinating subject! Very well reviewed in 2022.
Credits
CME:1.0, MOC:1.0