目的:评估1岁以下奶瓶喂养婴儿吞咽的纤维内窥镜评估(FEES)中与吞咽后残留亚位点相关的误吸风险。
方法:这是一项回顾性配对队列研究,在一所三级儿童医院进行。在间隔<5天的同一婴儿中进行的FEES和视频透视吞咽研究(VFSS)试验通过匹配的推注稠度和瓶流速进行配对。阳性误吸由“或规则”定义,其中当匹配对中的FEES或VFSS为阳性时,误吸为阳性。
结果:来自29例患者(16例男性;平均[SD]年龄,包括2.9[2.8]个月)。积极的误吸率,如\"或规则\"所定义,59%(51/87)。在费用中,吞咽后梨状窦残留物占16%(14/87),前连合残留物占27%(31/87)。梨状窦残留(比值比[OR]5.4,95%置信区间[CI]1.9-19.3,p<0.01)和FEES的前连合残留(OR2.5,95%CI1.1-6.1,p=0.03)增加了阳性误吸的风险。在新生儿亚组中,<1月龄,多变量校正分析显示,前连合残留物对误吸的诊断准确性优于年龄较大的婴儿(总体为70%vs.42%,p<0.01;灵敏度60%vs.10%,p<0.01),而梨状窦残留物的准确性较差(总体41%vs.70%,p=0.02;灵敏度13%vs.43%,p=0.02)。
结论:这项研究表明,婴儿FEES期间梨状窦和前连合残留与误吸风险增加五倍和两倍相关,分别。
方法:使用回顾性配对队列,这项研究评估了FEES中吞咽后残留物对预测误吸的诊断准确性.喉镜,2023年。
OBJECTIVE: To assess the risk of aspiration associated with post-swallow residue subsites in Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in bottle-fed infants <1 year of age.
METHODS: This is a retrospective matched-pairs cohort study at an academic tertiary children\'s hospital. FEES and Videofluoroscopic Swallowing Study (VFSS) trials performed within the same infant <5 days apart were paired by matching bolus consistency and bottle flow rate. Positive aspiration was defined by the \"or rule\" in which aspiration is positive when either FEES or VFSS within a matched pair is positive.
RESULTS: Eighty-seven FEES-VFSS matched pairs from 29 patients (16 males; mean [SD] age, 2.9 [2.8] months) were included. The rate of positive aspiration, as defined by the \"or rule\", was 59% (51/87). In FEES, post-swallow pyriform sinus residue was present in 16% (14/87) and anterior commissure residue 27% (31/87). Risk of positive aspiration was increased by pyriform sinus residue (odds ratio [OR] 5.4, 95% confidence interval [CI] 1.9-19.3, p < 0.01) and anterior commissure residue in FEES (OR 2.5, 95% CI 1.1-6.1, p = 0.03). In the neonate subgroup, <1 month of age, multivariate-adjusted analysis showed that anterior commissure residue had better diagnostic accuracy for aspiration than in older infants (overall 70% vs. 42%, p < 0.01; sensitivity 60% vs. 10%, p < 0.01), whereas pyriform sinus residue had worse accuracy (overall 41% vs. 70%, p = 0.02; sensitivity 13% vs. 43%, p = 0.02).
CONCLUSIONS: This study demonstrates that pyriform sinus and anterior commissure residue during infant FEES were associated with fivefold and twofold increased risk of aspiration, respectively.
METHODS: Using a retrospective matched-pairs cohort, this study assesses the diagnostic accuracy of post-swallow residue in FEES for predicting aspiration. Laryngoscope, 134:1431-1436, 2024.