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- Title
Swallowing Function After Laryngeal Cleft Repair: More Than Just Fixing the Cleft.
- Authors
Osborn, Alexander J.; Alarcon, Alessandro; Tabangin, Meredith E.; Miller, Claire K.; Cotton, Robin T.; Rutter, Michael J.
- Abstract
Objectives/Hypothesis: To evaluate and describe the swallowing function in children after laryngeal cleft repair. Study Design: Ten-year (2002-2012) retrospective chart review. Setting: Academic tertiary care pediatric otolaryngology practice. Methods: Records of 60 children who had surgical repair of laryngeal cleft (ages 2 weeks-14 years) and postoperative functional endoscopic evaluation of swallowing or videofluoroscopic swallow studies were examined retrospectively. Results: Twenty-nine children had one postoperative swallow evaluation, 19 children had two, 4 children had three, 5 children had four, and 3 children had five. Median time to the first evaluation was 10.8 weeks (interquartile range [IQR]: 36.5, 231). On the final swallow evaluation, 34 (57%) children demonstrated normal swallowing parameters, 12 (20%) children showed penetration, and 14 (23%) children showed aspiration. Forty-three (72%) children were able to take everything by mouth normally or with minor behavioral modifications, 11 (18%) children required thickened fluids, and six (10%) children were kept nil per os (NPO). Mean improvement on the penetration-aspiration (pen-asp) scale was 2.13. On multivariable analysis, neurodevelopmental issues and gastronomy tube use were associated with the need for NPO status. Conclusion: Despite a high rate of surgical success, a substantial minority of children have persistent swallowing dysfunction after laryngeal cleft repair. Swallowing dysfunction after repair is multifactorial and arises from concomitant neurologic, anatomic, or other comorbidities that contribute to oropharyngeal and pharyngeal dysphagia. Based on our results, we recommend a testing schedule for postoperative swallowing evaluations after cleft repair.
- Subjects
LARYNGEAL diseases; DEGLUTITION; POSTOPERATIVE period; DEGLUTITION disorders; COMORBIDITY; OROPHARYNX; PHYSIOLOGY; THERAPEUTICS
- Publication
Laryngoscope, 2014, Vol 124, Issue 8, p1965
- ISSN
0023-852X
- Publication type
Article
- DOI
10.1002/lary.24643