Application and Verification of Quantitative Objective Videofluoroscopic Swallowing Measures in a Pediatric Population with Dysphagia

Objective To investigate the feasibility of obtaining and utilizing objective measures of timing and displacement from videofluoroscopy performed in pediatrics. Study design Children (n = 121; mean age 38 months, range 9 days-21 years, SD 4 years) referred for videofluoroscopy were recruited. All underwent a standardized protocol including a mid-feed 20-second loop recorded at 25 frames per second. Videos were analyzed using objective digital measures of timing and displacement. Radiation dose was recorded. Results Quantitative measures were obtained in all children. Maximum opening of the pharyngoesophageal segment and timing measures were correlated with increasing age. Values were congruent with validated adult data. Mean radiation time was 1.58 minutes (range 0.15-3.47, SD 0.66), and mean radiation dose was 30.16 cGycm(2) (range 6.5-85 SD 15.17). Radiation dose (P = .21) and radiation time (P = .72) were not significantly different using the increased frame rate compared with an age-matched cohort (n = 100) prior to protocol change. Conclusions Objective quantitative measures of swallowing measurements can be obtained successfully from pediatric videofluoroscopy performed at high frame rates, without increasing radiation dose. Measures are biologically consistent, reproducible, demonstrate internal cross-correlation, and mirror adult data. These measures have potential to support targeted management and objective monitoring of change by pediatric feeding teams in the future.