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Pediatric Otolaryngology

Multidisciplinary Management of Pediatric Dysphagia: Solving the Swallow!

Sunday, October 1, 2023
5:00 PM - 6:00 PM East Coast USA Time
Location: 208AB

    Moderator(s)

  • Claire M. Lawlor, MD

    Pediatric Otolaryngologist
    Children's National Health Center
    Washington, DC, United States

    • Panelist(s)

  • Nancy M. Bauman, MD

    Physician, Director of Aerodigestive Clinic
    Children's National Health System
    Washington, DC, United States

  • Sona Sehgal, MD

    Clinical Associate Professor of Pediatric Gastroenterology
    Children's National Medical Center
    Washington , DC, United States

  • MC

    Maura E. Collins, CCC-SLP

    Speech-Language Pathologist
    Children's National Hospital
    Cincinnati, OH, United States

Disclosure(s):
Claire M. Lawlor, MD: No relevant relationships to disclose.
Sona Sehgal, MD: No relevant relationships to disclose.
PROGRAM DESCRIPTION: This multidisciplinary panel addresses pediatric dysphagia - an AAO-HNS targeted knowledge gap - and is comprised of pediatric otolaryngologists, a speech and language pathologist and a gastroenterologist, who specialize in treating pediatric dysphagia at a tertiary, free-standing children’s hospital. The panelists are members of an active multidisciplinary aerodigestive team in existence for >10 years. Case reports and videos illustrate the types of pediatric dysphagia, common diagnostic tests and management strategies.

Pediatric dysphagia can be isolated but often occurs with comorbid conditions and is best addressed by a multidisciplinary approach. Pediatric dysphagia is classified as oral, pharyngeal, (including aspiration/penetration), oropharyngeal (oral AND pharyngeal) and esophageal. Sensory, motor, anatomic, behavioral, and developmental etiologies are often identified.

Common diagnostic tools of pediatric dysphagia include a clinical evaluation of swallow, flexible endoscopic evaluation of swallow (FEES), endoscopy and video fluoroscopic swallow study (modified barium swallow). Based on study results, a comprehensive feeding plan is created for the child to allow for safe nutritional intake and progression toward developmentally appropriate oral motor skills. We will also discuss key aspects of the physical exam in an infant.

Use of compensatory strategies including thickened liquids, modified feeding equipment, feeding strategies and caregiver training will be illustrated. Surgical treatment of anatomic causes including post cricoid vascular cushion, type 2 laryngeal cleft, vocal cord dysfunction and cricopharyngeal achalasia will be presented. The clinical utility of the 7 point Functional Oral Intake Scale (FOIS) will be reviewed to facilitate the practitioner’s analysis of patient outcomes.

With thoughtful consideration, most pediatric patients with dysphagia can continue some form of oral alimentation for improved quality of life.

Attend this panel to broaden your knowledge of this fascinating subject! Very well reviewed in 2022.

OUTCOME OBJECTIVE 1: To understand dysphagia types (oral, pharyngeal, combined, esophageal) and use of diagnostic studies including bedside evaluation of swallow, FEES, endoscopy, and videofluoroscopy of swallow.

OUTCOME OBJECTIVE 2: To recognize the value of multidisciplinary care in managing pediatric dysphagia by employing feeding strategies, medications and surgical therapy to optimize nutritional status and oral alimentation.

OUTCOME OBJECTIVE 3: To review the value of the 7 point Functional Oral Intake Scale (FOIS) in standardizing assessment of feeding abilities and in assessing outcome of dysphagia management strategies.

BACKGROUND STATEMENT: It is not surprising that the Academy designated the complex subject of Pediatric Dysphagia as a knowledge gap topic. With didactics, videos and case reports, our well-established aerodigestive team (ENT, GI, SLP) will work diligently to expand audience knowledge of this enigmatic condition.