Motility Studies Useful in Neonatal Dysphagia

Manometry may better predict oral feeding success than the videofluoroscopic swallow study
By Rick Ansorge
HealthDay Reporter

FRIDAY, Jan. 30 (HealthDay News) -- In neonatal dysphagia, pharyngoesophageal motility studies combined with clinical observations during evaluation can play a useful role in the development of well-structured multidisciplinary feeding strategies, researchers report in the February issue of the Journal of Pediatric Gastroenterology and Nutrition.

Sudarshan R. Jadcherla, M.D., of the Ohio State University College of Medicine in Columbus, Ohio, and colleagues studied 20 dysphagic neonates who at a median of 41.36 weeks postmenstrual age underwent a crib-side swallow-integrated pharyngoesophageal motility assessment of basal and adaptive swallowing reflexes with a micromanometry catheter and pneumohydraulic water perfusion system. Multidisciplinary feeding strategies were initiated based on the study observations.

At discharge, 15 of the neonates had achieved oral feeding success while the other five required chronic tube feeding, the researchers report. Compared to the chronic tube feeders, the investigators found that the primary oral feeders had significantly different pharyngoesophageal manometry correlates for swallow frequency, swallow propagation, presence of adaptive peristaltic reflexes, oral feeding challenge test results, and upper esophageal sphincter tone. They also found that feeding outcomes were not significantly related to videofluoroscopic swallow study results or disease characteristics.

"The findings of this study potentially have important clinical implications in the evaluation and management of neonatal dysphagia, in that manometry may be a better predictor than the videofluoroscopic swallow study in identifying those patients that are more likely to succeed with oral feeding abilities using a vigorous intervention program," the authors write.

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