Clinical and instrumental swallowing evaluation in children with cerebral palsy

Moisés Andrade dos Santos de Queiroz; Izabella Santos Nogueira de Andrade; Renata Cavalcante Barbosa Haguette; Erik Frota Haguette

Rev. soc. bras. fonoaudiol. vol.16 no.2 São Paulo abr./jun. 2011

PURPOSE: To investigate the main manifestations of dysphagia in clinical and instrumental evaluation of swallowing in children with cerebral palsy. METHODS: Cross-sectional study of 50 children with cerebral palsy. The data collection consisted of clinical speech-language pathology evaluation and fiberoptic endoscopic evaluation of swallowing for the detection of the main manifestations of dysphagia present in oral preparatory, oral and pharyngeal phases of swallowing, with different food consistencies and types of cerebral palsy. RESULTS: There was no significant influence of age and type of cerebral palsy over the presence of dysphagia manifestations. The main manifestations in the clinical evaluation were: anterior premature spillage for liquids (70%); cough during swallowing of liquids (60%); decreased solid bolus formation (57.9%); presence of food residues on the oral cavity after deglutition of solids (47.4%); extended oral transit of thick food (47.1%); and presence of wet voice after swallowing of liquids (30%). The main manifestations of dysphagia in instrumental evaluation were: extended pharyngeal transit of thick food (79%); posterior premature spillage for liquids (77.5%); presence of thick food residues on the pharyngeal cavity after swallowing (58.8%); laryngeal penetration for liquids (37.5%), and tracheal aspiration for liquids (20%). Laryngeal sensibility was altered in only 16% of the sample. CONCLUSION: Clinical and instrumental evaluations of swallowing are complementary and essential in the diagnosis of oropharyngeal dysphagia in children with cerebral palsy.

Palavras-chave : Deglutition; Cerebral palsy [complications]; Deglutition disorders [diagnosis]; Pharynx [physiopathology]; Child.

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