September 2019 HSC Section 1 Congenital and Pediatric Problems

International Journal of Pediatric Otorhinolaryngology 115 (2018) 10–18

E. Cole et al.

Fig. 3. Presenting symptoms and resolution of symptoms in each age group. (A) Stridor was signi fi cantly less common in children in the 12 – 36-month group than in those in the 0 – 3 month or 4 – 11-month groups. Cyanosis was less common in children in the 12 – 36-month group compared with the 0 – 3-month group. (B) There were no signi fi cant di ff erences in the percentages of patients experiencing resolution in each age group. *p < 0.05 using Chi-squared or Fisher's exact tests. Abbreviations: FTT= Failure to Thrive.

parameters between the age groups.

FEES post-injection also had aspiration during MBS; however, an ad- ditional 7 patients who did not have aspiration during FEES had as- piration on MBS (McNemar χ 2 (1) =7.00, p =0.016). There was no signi fi cant agreement between the patients with penetration during FEES ( Fig. 5 A) or penetration ( Fig. 5 C) or aspiration ( Fig. 5 D) during MBS and abnormal CSE, or between patients with penetration during FEES and MBS ( Fig. 5 E).

3.7. Comparisons of swallowing evaluations

The second aim of the study was to analyze the discrepancies be- tween the proportion of patients experiencing resolution on CSE, FEES, and MBS in this population of young children undergoing injection laryngoplasty ( Fig. 5 ). These analyses were only performed for thin li- quids due to inadequate sample sizes for thicker consistencies. There was complete agreement between abnormal fi ndings on CSE and as- piration during FEES before (kappa = 1.000 ± SE 0.577, p =0.042) and after (kappa =1.000 ± SE 0.577, p = 0.042) injection ( Fig. 5 B). However, sample sizes were small (3 patients had both CSE and FEES pre- and post-injection). There was signi fi cant agreement between FEES and MBS fi ndings of aspiration post- fi rst injection (kappa = 0.308 ± SE 0.170, p = 0.035) ( Fig. 5 F). The 4 patients with aspiration during

4. Discussion

Injection laryngoplasty for type 1 laryngeal cleft is e ff ective and safe for children 0 – 3 months of age. Children in this age group presented with more respiratory symptoms such as stridor and cyanosis. The timing between presentation, diagnosis, and initial treatment also varied signi fi cantly among age groups. Those who were in the 0 – 3- month age group had signi fi cantly shorter times between presenting

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