Effect of a standardized fluoroscopic procedural approach on fluoroscopy time during infant modified barium swallow studies

Patel, Terral; Clemmens, Clarice S.; Bradburn, Kathryn; Beckstrand, Michael; McGhee, Heather C.; McKelvey, Keeley L.; Simmons, Cephus E.; Hill, Jeanne G.; McGrattan, Katlyn

doi:10.1016/j.ijporl.2020.110396

Cited by 7 publications

(5 citation statements)

References 17 publications

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“…In the future, a prospective study designed to isolate changes in swallow with respect to positioning during the same bottle feed is needed. It has been demonstrated that swallowing physiology throughout feed changes in as little as 1.5 minutes in infants, therefore controlling for the variable of time is also important ( 23 ). Additionally, nipple flow rate control was not possible in our study.…”

Section: Discussionmentioning

confidence: 99%

Effects of Body Positioning on Laryngeal Penetration and Aspiration in Children with Unilateral Vocal Cord Paralysis

Monaghan,

McGhee,

Yuen

et al. 2023

TAO

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Objective: To evaluate laryngeal penetration and aspiration in upright and side-lying positions in children with unilateral vocal cord paralysis (VCP) who underwent modified barium swallow study (MBSS). Methods: A retrospective chart review (Pro00089051) of pediatric patients who were diagnosed with unilateral VCP and underwent MBSS was performed. Patients were identified using diagnostic code for VCP and based on diagnosis via flexible laryngoscopy. Once identified, MBSS notes were reviewed for data regarding laryngeal penetration, tracheal aspiration, and body position during the exam. Information was collected on the various consistencies of liquids used. The order of positioning was recorded in patients who had undergone both positions during the study. Data was analyzed using chi-square analysis. Results: 811 patients had undergone MBSS between 2011 and 2014. Of these, 90 patients were isolated with unilateral VCP, and of those 90 patients, 23 (26%) had undergone MBSS in both side-lying and upright positions. When all 90 patients were evaluated, there was no difference in penetration or aspiration noted in the side-lying or upright position with thin liquids. Importantly, among the 23 (26%) patients that had been studied in both positions, there were no significant differences in penetration or aspiration relating to body position with any consistency. Conclusion: Rates of penetration and aspiration were not associated with body position in patients who had undergone MBSS at our institution. However, due to an incomplete data set and a small sample size of those who underwent MBSS in both positions, these results should be further explored in prospective studies.

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Section: Discussionmentioning

confidence: 99%

Effects of Body Positioning on Laryngeal Penetration and Aspiration in Children with Unilateral Vocal Cord Paralysis

Monaghan,

McGhee,

Yuen

et al. 2023

TAO

Self Cite

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“…Swallowing trials were administered starting with thin liquids (VARIBAR Thin Liquid barium sulfate powder [40% w/v] mixed with sterile water per manufacturer instructions) via the slowest available flow of each infant’s typical bottle system. 1,30 Subsequent bolus presentations and compensatory interventions (eg, change in liquid consistencies/viscosity, change in nipple flow rates) were determined as clinically indicated based on the infant’s response to the previous swallowing trial, per the discretion of the evaluating speech pathologist and radiologist. 1,30-33 All MBS were conducted using continuous fluoroscopy and were recorded at 30 frames per second on a high-resolution TIMS recording system (TIMS Medical Video Platform, Foresight Imaging, LLC).…”

Section: Methodsmentioning

confidence: 99%

“…Swallowing trials were administered starting with thin liquids (VARIBAR Thin Liquid barium sulfate powder [40% w/v] mixed with sterile water per manufacturer instructions) via the slowest available flow of each infant's typical bottle system. 1,30 Subsequent bolus presentations and compensatory interventions (eg, change in liquid consistencies/ viscosity, change in nipple flow rates) were determined as clinically indicated based on the infant's response to the previous swallowing trial, per the discretion of the evaluating speech pathologist and radiologist. 1,[30][31][32][33] All MBS were conducted using continuous fluoroscopy and were recorded at 30 frames per second on a high-resolution TIMS recording system (TIMS Medical Video Platform, Foresight Imaging, LLC).…”

Section: Standard Mbs Procedures At Vcuhmentioning

confidence: 99%

The Influence of Side-Lying Position on Oropharyngeal Swallow Function in At-Risk Infants: An Exploratory Study

Smith

Kamarunas

O'Donoghue

2023

Clin Pediatr (Phila)

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This investigation assessed the effect of side-lying position on infant oropharyngeal swallow physiology. Infant modified barium swallow studies (MBS) recordings were retrospectively examined in matched-pairs comparing at-risk infants swallowing in both an upright/cradled position and a side-lying position. Swallow parameters were measured independently and through a consensus coding approach. Infants fed in side-lying position showed a decrease in airway invasion severity as compared with when those same infants were fed in an upright/cradled position ( P = .009). Bolus location at the time of swallow initiation was higher when infants were fed in side-lying position as compared with cradle position ( P = .024), representing decreased risk of airway invasion. Infants fed in side-lying position demonstrated fewer swallows per breaths ( P = .032). This pilot study validates the need for additional research to further define the mechanisms related to this improvement, and to determine how diagnosis and medical stability moderate these findings.

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“…It is also important to keep in mind the radiation exposure in this procedure, particularly when repeat assessment is needed. Studies have demonstrated that using specific protocols, including appropriate speed of acquisition of images (current gold standard is 30 frames per second), as well as pausing fluoroscopy to allow for fatigue and reinitiating the imaging, can help with decreasing overall radiation per study [18,19]. In the senior author's opinion, a clinician should be judicious with repeat MBS when no intervention (i.e.…”

Section: Key Pointsmentioning

confidence: 99%

Current opinion in otolaryngology and head and neck surgery: the role of the otolaryngologist in the management of pediatric dysphagia

Farrell,

Raol

2023

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review Dysphagia affects at least 1% of the pediatric population. This prevalence further increases in patients who are born prematurely or who have underlying neuromuscular or cardiopulmonary disorders. A multidisciplinary team approach, including an Otolaryngologist, can help promote an expedited diagnosis and therapeutic regimen, ensuring that the patient receives adequate nutrition needed for growth and development. Recent findings The development and growth of multidisciplinary aerodigestive clinics have improved outcomes in pediatric patients with dysphagia. If a structural concern is noted on examination, there remain a multitude of medical and surgical options to help improve patient outcomes and swallow. These treatment options are usually multimodality and specific interventions may be employed to target a specific and notable abnormality. Summary Pediatric dysphagia is a complex concern. For the otolaryngologist, etiologies with surgical targets may include ankyloglossia, tonsillar hypertrophy, laryngomalacia, laryngo-esophageal cleft, vocal fold movement impairment, and cricopharyngeal achalasia. The development and formalization of a multidisciplinary approach has streamlined and broadened treatment options for these patients. An otolaryngologist is integral as part of the treatment team of these patients.

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Effect of a standardized fluoroscopic procedural approach on fluoroscopy time during infant modified barium swallow studies

Cited by 7 publications

References 17 publications

Effects of Body Positioning on Laryngeal Penetration and Aspiration in Children with Unilateral Vocal Cord Paralysis

Effects of Body Positioning on Laryngeal Penetration and Aspiration in Children with Unilateral Vocal Cord Paralysis

The Influence of Side-Lying Position on Oropharyngeal Swallow Function in At-Risk Infants: An Exploratory Study

Current opinion in otolaryngology and head and neck surgery: the role of the otolaryngologist in the management of pediatric dysphagia

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