Chest
Clinical InvestigationsEsophagusChronic Aspiration Without Gastroesophageal Reflux as a Cause of Chronic Respiratory Symptoms in Neurologically Normal Infants
Section snippets
Materials and Methods
The records of otherwise healthy infants who were referred between January 1997 and December 1999 to the Department of Pediatric Pulmonology at Children's Hospital in Columbus, OH, who underwent 24-h esophageal pH monitoring and videofluoroscopic swallow studies (VSSs) as part of an evaluation for recurrent stridor and/or wheezing were reviewed (n = 112) with the approval of the Children's Hospital Institutional Review Board. The Children's Hospital Pulmonary Division sees approximately 5,000
Results
Of 112 infants in this study, 26 infants (23%) had abnormal results for both the 24-h esophageal pH monitoring study and the VSS, 55 infants (49%) had normal results for both the 24-h esophageal pH monitoring study and the VSS, 18 infants (16%) had abnormal results for the 24-h esophageal pH monitoring study but normal results for the VSS, and 13 infants (11.6%) had normal results for the 24-h esophageal pH monitoring study but abnormal results for the VSS. We focused on the last group, and the
Discussion
In a retrospective review8 of patients undergoing a videofluoroscopic-modified barium swallow study at Children's Hospital of Buffalo, NY, it was noted that the vast majority of patients who aspirated were dependent on caregivers for feeding (90%) and had a diagnosis of cerebral palsy (71%). Importantly, it was noted also that many of these aspirators did so silently (ie, aspiration was not accompanied by cough or choking). Abnormalities in pharyngeal swallow function, such as reduced
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