Erika S Armstrong1, Jenny Reynolds2, Sandra Carroll2, Chrysty Sturdivant2, Mustafa S Suterwala3. 1. Department of Communication Sciences and Oral Health, Texas Woman's University, Denton, TX, USA. 2. Department of Physical Medicine, Baylor University Medical Center, Dallas, TX, USA. 3. Division of Neonatology, Department of Pediatrics, Baylor University Medical Center, Dallas, TX, USA. Mustafa.Suterwala@BSWHealth.org.
Abstract
OBJECTIVE: To determine the diagnostic accuracy of videofluoroscopy (VFSS) and endoscopy (FEES) in detecting laryngeal penetration and tracheal aspiration in bottle-fed young infants in the NICU. STUDY DESIGN: VFSS and FEES findings of 22 infants were compared to each other and to a composite reference standard in this prospective study. Sensitivity, specificity, positive and negative predictive values were calculated for each assessment. RESULT: Agreement between VFSS and FEES was high (92%) for aspiration and moderate (56%) for penetration, with FEES detecting more instances of penetration. Compared to the composite reference standard, FEES had greater sensitivity and a higher negative predictive value for penetration than VFSS. Because of the low prevalence of aspiration, diagnostic accuracy could not be determined for aspiration for either assessment. CONCLUSION: FEES appears to be more accurate in detecting penetration in this population, and both assessments are valuable tools in a comprehensive feeding and swallowing evaluation.
OBJECTIVE: To determine the diagnostic accuracy of videofluoroscopy (VFSS) and endoscopy (FEES) in detecting laryngeal penetration and tracheal aspiration in bottle-fed young infants in the NICU. STUDY DESIGN: VFSS and FEES findings of 22 infants were compared to each other and to a composite reference standard in this prospective study. Sensitivity, specificity, positive and negative predictive values were calculated for each assessment. RESULT: Agreement between VFSS and FEES was high (92%) for aspiration and moderate (56%) for penetration, with FEES detecting more instances of penetration. Compared to the composite reference standard, FEES had greater sensitivity and a higher negative predictive value for penetration than VFSS. Because of the low prevalence of aspiration, diagnostic accuracy could not be determined for aspiration for either assessment. CONCLUSION: FEES appears to be more accurate in detecting penetration in this population, and both assessments are valuable tools in a comprehensive feeding and swallowing evaluation.
Authors: James A Curtis; James C Borders; Sarah E Perry; Avery E Dakin; Zeina N Seikaly; Michelle S Troche Journal: Dysphagia Date: 2021-04-10 Impact factor: 3.438