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Journal of the Korean Academy of Rehabilitation Medicine 2011;35(2):265-271.
Evaluating the Clinical Symptoms of Neonates with Suspected Dysphagia.
Lee, Kyeong Woo , Kim, Sang Beom , Lee, Jong Hwa , Kim, Tae Hyoung , Han, Dong Wook , Kim, Myo Jing
1Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan 602-715, Korea. thkim711125@naver.com
2Department of Pediatrics, Dong-A University College of Medicine, Busan 602-715, Korea.
Abstract
Objective
To evaluate the prevalence of dysphagia in neonates who showed abnormal findings on videofluoroscopic swallowing studies (VFSSs), and to compare the accuracy of the clinical evaluation with the VFSS results. Method A clinical investigation of 142 neonates admitted to a neonatal intensive care unit was carried out to evaluate the presence of low O2 saturation (<80%), symptoms of cyanosis, coughing and/or vomiting, nasal regurgitation, drooling saliva, voice change and crying during feeding. VFSSs were performed on the neonates who had at least one of these clinical abnormalities.
Results
Of the 142 patients, 37 (26.1%) had at least one of the clinical symptoms of dysphagia. Twenty two of 37 (59.5%) showed abnormal findings on the VFSS. The patients exhibiting cyanosis and coughing during feeding had a higher incidence of aspiration (11 of 11, 100%) on the VFSSs than did the patients with other symptoms: cyanosis (3 of 13, 30.8%), cyanosis with vomiting (0 of 2, 0.0%), coughing without cyanosis (2 of 5, 40.0%), voice change (2 of 2, 100%) and nasal regurgitation (1 of 3, 33.3%). Conclusion The prevalence of laryngeal penetration or subglottic aspiration among those neonates who were clinically suspected of dysphagia was 59.5%. Coughing with cyanosis during feeding was the best predictor of both these abnormalities.
Key Words: Dysphagia, Videofluoroscopic swallowing study, Neonate


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