To evaluate and to compare the findings of oral and pharyngeal phases of swallowing in children with both spastic tetraparetic cerebral palsy (STCP) and with athetosic cerebral palsy (ACP). Patients and methods. 11 children were evaluated, with their ages ranging from 10 months to 8 years old, through both clinical assessment and videofluoroscopic evaluation. Results. The children with STCP were more involved at the neurologic, clinical and speech-language and hearing aspects. At the oral phases all the children had presented some involvement. At the pharyngeal phases the clinical signs of aspiration were identified in 10 children. It was observed aspirations in 80% of children with STCP and in 67% with ACP. The changes on swallowing were similar in both cerebral palsy groups, but the performance of the children with STCP was inferior. Conclusion. The videofluoroscopy was an important method which makes possible the verification of aspirations, helping the professionals at the therapeutical program for these children.
The objective of this paper is to compare the airway protection mechanism during the swallowing in children with cerebral palsy (CP), in two standard postures. The videofluoroscopy evaluation of swallowing was carried out in 18 children from two to 13 years old, from both genders, carriers of specific cerebral palsy conditions: spastic tetraparetic CP, atetosic CP or mixed who are usually fed in cervical hyperextension position. They were offered 3 and 5ml of two opaque food textures: thin paste food and liquid, and also free swallowing in seated position at 90º and cervical hyperextension. The analyses of aspiration and penetration events were conducted following an 8 level-scale (Penetration-Aspiration Scale), according to Rosenbek et. al. (1996), defined by the deepness that the material reaches across the airway and whether the material that enters is expelled or not. The cervical hyperextension was not an efficient compensation and that the swallowing process in this position was as favorable to the traqueal aspiration, as the swallowing process with positioning at 90º. With positioning in cervical hyperextension the children swallowed the smaller volume (3ml), in the liquid texture, with more safety to the airway, compared to the 5ml swallowing and the free swallowing of the same texture and positioning. There were not statistically significant differences between the children swallowing seated at 90º position and in cervical hyperextension; the same occurred with the tested food textures. Ultimately, could be also observed that the children's age did not present correlation with the answers obtained with any of the remained variables.
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