Videofluoroscopic findings in children from 3 to 6 years old with cerebral palsy

Abstract

Introduction: Cerebral palsy (CP) is frequently accompanied by feeding and swallowing disorders (FSD). An early diagnosis of FSD prevents numerous complications. Clinical assessment stands as the first approach to FSD, although it is insuficient to identify risk factors (laryngeal penetration and aspiration). For this purpose, a videofluoroscopic (VFC) evaluation is required. Objecti-ve: To describe and quantify VFC findings in a group of children with CP, aged 3 to 6 years, GMFCS I to V. Patients and Methods: 50 patients underwent a VFC after their Gross Motor Functional Classification System (GMFCS) level was determined and no contraindications for the exam were identified. In addition, the researchers conducted an assessment to establish the presence of signs of unsafe and incompetent swallowing, food consistency tolerance, and mealtime positioning requirements, in order to allow a more comfortable VFC procedure. Results: There was male predominance, average age of 5 years, 78% GMFCS III-V. Up to 94% had one or more VFC alterations at some point of the exam. 28% had no chewing ability, being all the cases GMFCS V. Con-sidering the deglutition eficacy, the commonest alteration was residue in the vallecula (86%), while the most frequent for swallowing safety was posterior spillage in the oral phase (68%). 26% presented silent tracheal aspiration. In the esophageal phase the findings were poor esophageal transit (30%) and gastroesophageal reflux (8%). Conclusions: VFC identified potentially risks in every GMFCS level of children with CP. Some of the VFC alterations are silent, even in mild motor impairment cases.