The pros and cons of videofluoroscopic assessment of swallowing in children

Abstract

In the last 20 years there has been increasing use of videofluoroscopy (VFSS) as part of the assessment and management of oropharyngeal dysphagia in children. It is from and during these assessments that management is often trialled and planned. A critical review of the literature was undertaken to examine the pros and cons of VFSS assessment in children. The aim was to determine what evidence existed for the use of VFSS in the diagnosis and management of dysphagia in children. There is a large literature concerning the use of VFSS in children and adults. The majority overwhelmingly recommends VFSS as a useful adjunct in the assessment and management of dysphagia. In particular, many published articles focus on how VFSS aids in the identification and confirmation of aspiration. VFSS is a commonly used clinical procedure in paediatric dysphagia. The authors identified 17 original articles that contained patient data and examined the use of VFSS in children. Results revealed that VFSS has not been compared with other investigative procedures (e.g. nasoendoscopy) to determine whether it yields the same or better results or is cost effective in children. Very few studies have sought to examine whether the use of VFSS in children result in better health outcomes. Interpretation of the existing data was affected by small sample sizes, the age range of the children studied and diagnostic groups. Future research priorities are identified.