EN
TÜRKÇE
Oral Presentation - 17
FEES in complex pediatric patients -initial experience, indications, and outcomes
S Bergmann, A Holler, O Muensterer
Department of Pediatric Surgery, Dr. von Hauner Children´s Hospital, LMU Hospital Munich
purpose
FEES (flexible/fiberoptic endoscopic evaluation of swallowing) is widely regarded as a safe and valid method to detect aspiration while eating and drinking. It is also used to classify dysphagia and grade of aspiration in children (Printza et al., 2022; Miller & Willging, 2020). In children with EA, precise assessment of swallowing is an essential element for distinction between oropharyngeal and oesophageal dysphagia. Nevertheless, in many countries, indications and practice of FEES differ widely, and no obligatory or standarized training is necessary (Pizzorni et al; 2024). In this presentation, we describe our experience of implementing FEES in a children’s hospital and propose inclusion/exclusion criteria.
method
Eligible children were recruited among patients who presented with dysphagia. The cases were discussed in a multidicsciplinary team. If a consensus was reached on a reasonable indication, FEES was carried out. The findings were correlated with clinical information, other imaging findings and with published literature.
results: Until time of submission, a total of 14 children underwent FEES from February 2024 until November 2024. Main indications included unclear dysphagia and unknown risk of aspiration in children with EA (n=6), with syndromatic disease (n=2) and children with wet voice (n=2). An additional (laryngeal) diagnosis was established in 4 cases. There were no complications. Careful composition of “Pediatric-FEES-team” as well as patient communication in advance of FEES are determined as centerpieces for successful assessment.
conclusion
Pediatric FEES as a safe and valid assessment needs critical rethinking in case of children with complex medical conditions. In accordance with the scientific literature, team structure and professional experience in pediatric dysphagia as well as feeding issues should be considered. The benefits of FEES examination must be weighed against the stress/burden of the examination. FEES and potential consequences for all-daily-life should be considered in advance.