Derangement of swallowing in children with myelomeningocele

Fernbach, Sandra K.; McLone, David G.

doi:10.1007/bf02386764

Cited by 14 publications

(7 citation statements)

References 27 publications

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“…In a prospective study of infants with MMC with flexible fiberoptic laryngoscopy, Linder et al found that 4 out of 22 children had dysphagia with aspiration; 3 of them had bilateral vocal fold motion impairment [Linder and Lindholm, 1997]. Some children will require gastrostomy tube placement to maintain nutrition or prevent pulmonary aspiration [Fernbach and McLone, 1985;Bowman et al, 2001]. Mortality is high in subjects with abnormal respiratory function requiring tracheotomy [McLone and Dias, 2003].…”

Section: Swallowmentioning

confidence: 99%

Feeding and swallowing dysfunction in genetic syndromes

Cooper-Brown

Copeland

Dailey

et al. 2008

Dev Disabil Res Revs

150

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Children with genetic syndromes frequently have feeding problems and swallowing dysfunction as a result of the complex interactions between anatomical, medical, physiological, and behavioral factors. Feeding problems associated with genetic disorders may also cause feeding to be unpleasant, negative, or even painful because of choking, coughing, gagging, fatigue, or emesis, resulting in the child to stop eating and to develop behaviors that make it difficult, if not impossible, for a parent to feed their child. In addition, limited experiences with oral intake related to the medical or physical conditions, or other variables such as prematurity, often result in a failure of the child's oral motor skills to develop normally. For example, a child with Pierre Robin sequence may be unable to successfully feed orally, initially, due to micrognathia and glossoptosis. Oral-motor dysfunction may develop as a result of both anatomical problems, (e.g., cleft lip/palate), lack of experience (e.g., s/p. surgery), or oral motor abnormalities (e.g., brain malformation). Neuromotor coordination impairments such as those associated with Down syndrome (e.g., hypotonia, poor tongue control, and open mouth posture) frequently interfere with the acquisition of effective oral-motor skills and lead to feeding difficulties. Management of these phenomena is frequently possible, if an appropriate feeding plan exist that allows for three primary factors: (1) feeding program must be safe, (2) feeding program must support optimal growth, and (3) feeding program must be realistic. Researchers have demonstrated the utility of behavioral approaches in the treatment of feeding disorders, such as manipulations in the presentation of foods and drink and consequences for food refusal and acceptance (e.g., praise, extinction, contingent access to preferred foods). However, because a child's failure to eat is not frequently the result of a single cause, evaluation and treatment are typically conducted by an interdisciplinary team usually consisting of a behavioral psychologist, pediatric gastroenterologist, speech pathologist, nutrition, and sometimes other disciplines. This chapter provides an overview of some of the feeding difficulties experience by some of the more common genetic disorders including identification, interventions, and management.

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Section: Swallowmentioning

confidence: 99%

Feeding and swallowing dysfunction in genetic syndromes

Cooper-Brown

Copeland

Dailey

et al. 2008

Dev Disabil Res Revs

150

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“…Patients with MMC may present exacerbation of gag reflex due to dysphagia as a result of cranial nerve injury related to the nonclosure of the neural tube . Another explanation for the gag reflex is that people with poor hygiene do not stimulate mouth desensitization, which contributes to the recurrence of reflexes during the dental treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with MMC may present exacerbation of gag reflex due to dysphagia as a result of cranial nerve injury related to the nonclosure of the neural tube. 29 Another explanation for the gag reflex is that people with poor hygiene do not stimulate mouth desensitization, 30 which contributes to the recurrence of reflexes during the dental treatment. In this case, the patient' s reflexes were caused by physical stimuli and handling of the oral cavity, use of saliva ejector, and three-way syringe and even saliva accumulation.…”

Section: Dental Care In Myelomeningocele Patientsmentioning

confidence: 99%

Strategies and dental care in the treatment of patients with myelomeningocele

Bignardi

Prates

Rossi

et al. 2018

Special Care in Dentistry

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Myelomeningocele (MMC) is a congenital malformation that occurs in the embryonic period, characterized by failure in closure of the caudal portion of the neural tube during central nervous system formation. Alterations and complications can be associated with this condition, such as hydrocephalus, neurogenic bladder, orthopedic problems, and motor and cognitive impairment. This patients with MMC also have predisposition to develop latex allergy and high caries risk and activity due to deficient oral hygiene, fermentable carbon hydrate-rich diet and prolonged use of sugar-containing oral medications. This paper reports the oral findings and dental treatment in a 15-year-old female patient diagnosed with MMC and describes the strategies used to improve dental treatment conditions and reduce the impact of associated risks to her health. The measures and precautions adopted in this case could be useful to reduce the barriers for patients with the same condition to access oral health care: regular visits to the dentist, initiating as early as possible; frequent reinforcement of oral homecare instructions and diet counseling; minor adaptions to the dental chair and dental office to improve ease of access due to patients' mobility problems; prevention of latex-related allergic reactions; reduction of gag reflex during dental procedures.

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“…Lack of visualization of the rectum on T1‐weighted images raises the possibility of an anatomic abnormality such as distal atresia/obstruction that is often associated with bowel dilation . However, cases of isolated anorectal malformation are not always associated with bowel dilation and therefore may need to be considered along with a functional etiology in fetuses with open spinal dysraphism, who are known to have varying degrees of bowel dysfunction and impaired fetal swallowing . That being said, it has not yet been established what distribution of meconium signal should be expected in the setting of open spinal dysraphism on fetal MRI.…”

Section: Introductionmentioning

confidence: 99%

“…11,12 However, cases of isolated anorectal malformation are not always associated with bowel dilation and therefore may need to be considered along with a functional etiology in fetuses with open spinal dysraphism, who are known to have varying degrees of bowel dysfunction and impaired fetal swallowing. [13][14][15]…”

Section: Introductionmentioning

confidence: 99%