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2023

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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PAEDIATRIC VIDEOFLUOROSCOPIC SWALLOW STUDY (VFSS): A STEP-BY-STEP APPROACH

Ana Forjaco; Rita Prata; Ana Isabel Rega; Pedro Alves

1 - Serviço de Radiologia, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa;
2 - Serviço de Radiologia, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa;
3 - Terapia da Fala, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa;
4 - Serviço de Radiologia, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa;

- Publicação sob a forma de poster electrónico no International Pediatric Radiology Congress 2021 (11/10/2021-15/10/2021)

Resumo:
Introduction and objectives: Brief review of the Videofluoroscopic Swallow Study (VFSS) technique and the main specificities of its use in paediatrics, including the formulation of a step-by-step approach to this technique.
Materials and methods: Research of terms such as VFSS, oropharyngeal dysphagia and paediatrics in PubMed. Review of relevant articles. Selection of original sample images of VFSS in patients treated in a paediatric university hospital.
Results: Swallowing problems are seen in up to 25% of all children and may occur because of developmental disorders, neurological conditions, gastroesophageal reflux or anatomical anomalies. Physicians in charge of paediatric patients should be aware that malnutrition and respiratory diseases are frequently caused by unrecognized dysphagia and silent aspiration. VFSS is a radiographic procedure that provides a dynamic view of the swallowing process. This process occurs in three main stages - oral, pharyngeal, and oesophageal - which have specific characteristics that must be recognized in the evaluation of a paediatric VFSS. The alteration of these phases results in different types of dysphagia, whose characteristics are typical of the children’s underlying disease. The swallowing reflex and airway protection are among the most important aspects to be assessed in the study. Overall, an interdisciplinary team approach improves global assessment and therapy planning, based on clinical and imaging findings.
Conclusions:  Swallowing difficulties can severely compromise pulmonary health and nutritional intake of paediatric patients. VFSS is the gold standard for the definitive evaluation of dysphagia in children. The success of this technique depends on the knowledge of the main phases of the swallowing process and the main specificities of the paediatric population.

Palavras Chave: Deglutição, Disfagia, Pediatria, Radiologia