Studies for Evaluation of Aspiration

Studies for evaluation

These studies are required in children who are suspected of having aspiration from above (food or saliva getting into the child’s windpipe). This is usually seen in children with neurological problems like cerebral palsy , neurodegenerative disorders, Neuromuscular disorders, etc. Aspiration from above would lead to recurrent pneumonia in these children and lead to lung damage.

These studies would document that the child is aspirating. This would help us plan the plan of management.

Video-Flouroscopic Swallow Study(VFSS)

  • This is also known as a Modified Barium Swallow (MBS)
  • Flouroscopy is done in various positions and food mixed with barium is given.
  • A standard protocol is utilized for administration of barium mixed with food of varying consistencies.  Initially foods of thinner consistencies are given  and later foods of thicker viscosities are given as tolerated. The typical protocol utilizes thin liquid (milk), thick liquid (thick juice), puree, and solid.
  • Food can be seen entering the windpipe of the child.
  • At our hospital these studies are performed jointly by a pediatric pulmonologist and a radiologist.

Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

  • The Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is a procedure used to evaluate the pharyngeal stages of swallowing by pediatric pulmonologists. The aim is to detect aspiration and safe diet which the child can eat.
  • A thin flexible fiberoptic bronchoscope or a laryngoscope is passed through the nose to the hypopharynx so as to visualize the glottis and vocal cords.
  • The child is seated in a functional feeding position and are offered a variety of food consistencies as in a VFSS but without Barium. The study is seen live and recorded.