Skip to main content
SpringerLink
Log in

Fiberoptic endoscopic evaluation of swallowing (FEES) study: the first report in children to evaluate the oropharyngeal dysphagia after esophageal atresia repair

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Background

The aim of this study was to evaluate the swallowing problems by fiberoptic endoscopic evaluation of swallowing (FEES) study in both short- and long-gap patients after esophageal atresia (EA) repair.

Methods

Hospital records of patients who had undergone surgery for EA were reviewed retrospectively. Patients were divided into two groups as short-gap (SG) group (n:16) and long-gap (LG) group (n:10) to compare the swallowing problems. FEES study was performed, and the results were discussed in detail.

Results

There were twenty-six (16 M/10 F) patients with a mean age at evaluation was 7.52 ∓ 3.68 years. Mean follow-up period was 75.35 ∓ 44.48 months. In FEES study, pharyngeal phase abnormalities were detected in 10 patients (38.4%). Pharyngeal phase abnormalities were detected significantly higher in LG group (p:0.015). Laryngeal penetration/aspiration was seen in four patients on FEES study (15.3%). All of them was in LG group (40%). Laryngeal penetration/aspiration was seen significantly higher in LG group (p:0.014).

Conclusion

This is the first study to conduct FEES study in children after esophageal atresia repair to evaluate their swallowing conditions. Even though our sample is small, swallowing problems are more common than expected in the cases of LG when compared to SG.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig.1

Similar content being viewed by others

Abbreviations

EA:

Esophageal atresia

FEES:

Fiberoptic endoscopic evaluation of swallowing

FOIS:

Functional oral intake scale

GER:

Gastroesophageal reflux

PAS:

Penetration–aspiration scale

VFSS:

Videofluoroscopy swallowing study

References

  1. Rintala RJ, Pakarinen MP (2013) Long-term outcome of esophageal anastomosis. Eur J Pediatr Surg 23:2019–2025. https://doi.org/10.1055/s-0033-1347912

    Article  Google Scholar 

  2. Tuğcu GD, Soyer T, Polat SE et al (2021) Evaluation of pulmonary complications and affecting factors in children for repaired esophageal atresia and tracheoesophageal fistula. Respir Med 181:106376. https://doi.org/10.1016/j.rmed.2021.106376

    Article  PubMed  Google Scholar 

  3. Rayyan M, Allegaert K, Omari T et al (2015) Dysphagia in children with esophageal atresia: current diagnostic options. Eur J Pediatr Surg 25:326–332. https://doi.org/10.1055/s-0035-1559818

    Article  PubMed  Google Scholar 

  4. Krishnan U, Mousa H, Dall’oglio L et al (2016) ESPGHAN-NASPGHAN guidelines for the evaluation and treatment of gastrointestinal and nutritional complications in children with esophageal atresia-tracheoesophageal fistula. J Pediatr Gastroenterol Nutr 63:550–570. https://doi.org/10.1097/MPG.0000000000001401

    Article  PubMed  Google Scholar 

  5. Lemoine C, Aspirot A, Le Henaff G et al (2013) Characterization of esophageal motility following esophageal atresia repair using high-resolution esophageal manometry. J Pediatr Gastroenterol Nutr 56:609–614. https://doi.org/10.1097/MPG.0b013e3182868773

    Article  PubMed  Google Scholar 

  6. Mahoney L, Rosen R (2016) Feeding difficulties in children with esophageal atresia. Pediatr Respir Rev 19:21–27. https://doi.org/10.1016/j.prrv.2015.06.002

    Article  Google Scholar 

  7. SerelArslan S, Demir N, Karaduman AA et al (2021) Dysphagia in children with EA-TEF from the perspective of pediatric surgeons in clinical settings. Dysphagia 36:644–649. https://doi.org/10.1007/s00455-020-10178-z

    Article  Google Scholar 

  8. Conforti A, Valfre L, Falbo M et al (2015) Feeding and swallowing disorders in esophageal atresia patients: a review of a critical issue. Eur J Pediatr Surg 25:318–325. https://doi.org/10.1055/s-0035-1559819

    Article  PubMed  Google Scholar 

  9. Cartabuke RH, Lopez R, Thota PN (2016) Long-term esophageal and respiratory outcomes in children with esophageal atresia and tracheoesophageal fistula. Gastroenterol Rep 4:310–314. https://doi.org/10.1093/gastro/gov055

    Article  Google Scholar 

  10. Yalçın S, Demir N, Serel S et al (2015) The evaluation of deglutition with videofluoroscopy after repair of esophageal atresia and/or tracheoesophageal fistula. J Pediatr Surg 50:1823–1827. https://doi.org/10.1016/j.jpedsurg.2015.07.002

    Article  PubMed  Google Scholar 

  11. Demir N, Arslan SS, Yalcin S et al (2017) Alterations in hyolaryngeal elevation after esophageal anastomosis: a possible mechanism for airway aspiration. J Pediatr Surg 52:1580–1582. https://doi.org/10.1016/j.jpedsurg.2017.04.001

    Article  PubMed  Google Scholar 

  12. Langmore SE, Shatz K, Olson N (1991) Endoscopic and videofluoroscopic evaluation of swallowing and aspiration. Ann Otol Rhinol Layrngol 100:678–681. https://doi.org/10.1177/000348949110000815

    Article  CAS  Google Scholar 

  13. Kelly AM, Drinnan MJ, Leslie P (2007) Assessing penetration and aspiration: how do videofluoroscopy and fiberoptic endoscopic evaluation of swallowing compare? Laryngoscope 117:1723–1727. https://doi.org/10.1097/mlg.0b013e318123ee6a

    Article  PubMed  Google Scholar 

  14. Willging JP (1995) Endoscopic evaluation of swallowing in children. Int J Pediatr Otorhinolaryngol 32:S107–S108. https://doi.org/10.1016/0165-5876(94)01174-v

    Article  PubMed  Google Scholar 

  15. Castilloux J, Noble AJ, Faure C (2010) Risk factors for short-and long-term morbidity in children with esophageal atresia. J Pediatr 156:755–760. https://doi.org/10.1016/j.jpeds.2009.11.038

    Article  PubMed  Google Scholar 

  16. Baxter KJ, Baxter LM, Landry AM et al (2018) Structural airway abnormalities contribute to dysphagia in children with esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 53:1655–1659. https://doi.org/10.1016/j.jpedsurg.2017.12.025

    Article  PubMed  Google Scholar 

  17. Crary MA, Carnaby Mann GD, Groher ME (2005) Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil 86:1516–1520. https://doi.org/10.1016/j.apmr.2004.11.049

    Article  PubMed  Google Scholar 

  18. Rosenbeck JC, Robbins JA, Roecker EB et al (1996) A penetration-aspiration scale. Dysphagia 11:93–98. https://doi.org/10.1007/BF00417897

    Article  Google Scholar 

  19. Marinschek S, Pahsini K, Aguiriano-Moser V et al (2020) Efficacy of a standardized tube weaning program in pediatric patients with feeding difficulties after successful repair of their esophageal atresia/tracheoesophageal fistula. Eur J Pediatr 179:1729–1737. https://doi.org/10.1007/s00431-020-03673-w

    Article  PubMed  PubMed Central  Google Scholar 

  20. Spitz L (2006) Esophageal atresia. Lessons I have learned in a 40-year experience. J Pediatr Surg 41:1635–1640. https://doi.org/10.1016/j.jpedsurg.2006.07.004

    Article  PubMed  Google Scholar 

  21. Rommel N, Rayyan M, Scheerens C et al (2017) The potential benefits of applying recent advances in esophageal motility testing in patients with esophageal atresia. Front Pediatr 5:137. https://doi.org/10.3389/fped.2017.00137

    Article  PubMed  PubMed Central  Google Scholar 

  22. Coppens CH, van den Engel-Hoek L, Scharbatke H et al (2016) Dysphagia in children with repaired oesophageal atresia. Eur J Pediatr 175:1209–1217. https://doi.org/10.1007/s00431-016-2760-4

    Article  PubMed  PubMed Central  Google Scholar 

  23. Yi YG, Shin HI (2019) Psychometrics of the functional oral intake scale for infants. Front Pediatr 7:156. https://doi.org/10.3389/fped.2019.00156

    Article  PubMed  PubMed Central  Google Scholar 

  24. Yi YG, Shin HI (2019) Psychometrics of the functional oral intake scale for children with dysphagia. J Pediatr Gastroenterol Nutr 71:686–691. https://doi.org/10.1097/mpg.0000000000002861

    Article  Google Scholar 

  25. Mahoney L, Rosen R (2017) Feeding problems and underlying mechanism in the esophageal atresia -Tracheoesophageal fistula patient. Front Pediatr 5:127

  26. Langmore SE (2017) History of fiberoptic endoscopic evaluation of swallowing for evaluation and management of pharyngeal dysphagia: changes over the years. Dysphagia 32:27–38. https://doi.org/10.1007/s00455-016-9775-x

    Article  PubMed  Google Scholar 

  27. Beer S, Hartlieb T, Müller A et al (2014) Aspiration in children and adolescents with neurogenic dysphagia: comparison of clinical judgment and fiberoptic endoscopic evaluation of swallowing. Neuropediatrics 45:402–405. https://doi.org/10.1055/s-0034-1387814

    Article  PubMed  Google Scholar 

  28. Da Silva AP, LubiancaNeto JF, Santoro PP (2010) Comparison between videofluoroscopy and endoscopic evaluation of swallowing for the diagnosis of dysphagia in children. Otolaryngol Head Neck Surg. 143:204–9. https://doi.org/10.1016/j.otohns.2010.03.027

    Article  PubMed  Google Scholar 

  29. Pavithran J, Puthiyottil IV, Kumar M, Nikitha AV, Vidyadhaaran S, Bhaskaran R et al (2020) Exploring the utility of fiberoptic endoscopic evaluation of swallowing in young children–a comprasion with videofluoroscopy. Int J Pediatr Otorhinolaryngol 138:110339. https://doi.org/10.1016/j.ijporl.2020.110339

    Article  PubMed  Google Scholar 

  30. Thottam PJ, Silva RC, McLevy JD et al (2015) Use of fiberoptic endoscopic evaluation of swallowing (FEES) in the management of psychogenic dysphagia in children. Int J Pediatr Otorhinolaryngol 79:108–110. https://doi.org/10.1016/j.ijporl.2014.11.007

    Article  PubMed  Google Scholar 

  31. Haller L, Osterbauer B, Maldonado K, Bhardwaj V, Bansal M, Peck K et al (2020) Factors impacting participation in flexible endoscopic evaluation of swallowing in children. Int J Pediatr Otorhinolaryngol 138:110323. https://doi.org/10.1016/j.ijporl.2020.110323

    Article  PubMed  PubMed Central  Google Scholar 

  32. Hörmann M, Pokieser P, Scharitzer M et al (2002) Videofluoroscopy of deglutition in children after repair of esophageal atresia. Acta Radiol 43:507–510. https://doi.org/10.1034/j.1600-0455.2002.430511.x

    Article  PubMed  Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not for profit sectors.

Author information

Authors and Affiliations

  1. Faculty of Medicine, Department of Pediatric Surgery, Ege University, Bornova, 35100, Izmir, Turkey

    Ulgen Celtik

  2. Faculty of Medicine, Department of Physical Therapy and Rehabilitation, Ege University, Bornova, 35100, Izmir, Turkey

    Sibel Eyigor

  3. Faculty of Medicine, Department of Pediatric Surgery, Ege University, Bornova, 35100, Izmir, Turkey

    Emre Divarci, Zafer Dokumcu, Coskun Ozcan & Ata Erdener

  4. Department of Otorhinolaryngology, Izmir Ekol Hospital, Cigli, Izmir, Turkey

    Baha Sezgin

  5. Faculty of Medicine, Department of Otorhinolaryngology, Ege University, Bornova, 35100, Izmir, Turkey

    Kerem Ozturk

Authors
  1. Ulgen Celtik
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sibel Eyigor
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Emre Divarci
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Baha Sezgin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Zafer Dokumcu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Coskun Ozcan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kerem Ozturk
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ata Erdener
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ulgen Celtik.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest to disclose

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Celtik, U., Eyigor, S., Divarci, E. et al. Fiberoptic endoscopic evaluation of swallowing (FEES) study: the first report in children to evaluate the oropharyngeal dysphagia after esophageal atresia repair. Pediatr Surg Int 38, 1227–1233 (2022). https://doi.org/10.1007/s00383-022-05169-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-022-05169-0

Keywords

Search

Navigation