WOFAPS 2025 8th World Congress of Pediatric Surgery

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Oral Presentation - 58

The relationship between upper esophageal width and length and oropharyngeal dysphagia in children with esophageal atresia

Tutku Soyer 1, Begüm Pişiren 1, Hatice Nursun Özcan 2, Selen Serel Arslan 3, Özlem Boybeyi 1, Berna Oğuz 2, Numan Demir 3
1 Hacettepe University Faculty of Medicine Department of Pediatric Surgery
2 Hacettepe University Medical Faculty Department of Radiology
3 Hacettepe University Faculty of Physical Therapy and Rehabilitation, Department of Physical Therapy and Rehabilitation

Aim: Insufficient airway closure and bolus residuals are common signs of oropharyngeal dysphagia (OFD) in esophageal atresia (EA). The dilated upper segment may cause delayed passage of bolus and increase the risk of penetration. Retrospective study was performed to evaluate the relationship between upper segment width and length and OFD in children with EA.

Methods: Patients operated on EA with a videofluoroscopic swallowing evaluation (VFS), and their healthy peers included. In addition to demographic features, VFS parameters were evaluated for bolus residue, penetration-aspiration (PAS) and dynamic imaging grade of toxicity (DIGEST) scores. Esophagographies were used to measure the upper-lower segment width, lengths according to the predetermined anatomical landmarks. Patients with (PAS>5) and without (PAS<6) OFD were compared for VFS findings and esophagography measurements. The width and length of upper-lower segments in EA patients were compared with healthy controls (HC).

Results: Nineteen EA patients and 23 HC included. The median age was 92 months (50-101) in OFD patients (n=7, 37%), whereas it was 93.5 months (68-103) in non-OFD group (n=12) (p>0.05). There was no difference between groups for bolus residuals, upper-lower segment widths and lengths (p>0.05). EA patients with and without OFD had significantly wider diameter in upper and lower segments than HC (p>0.001, p=0.002, respectively). Patients with gastroesophageal reflux (GER) had wider and longer lower segments than patients without GER (width; p=0.017, length; p= 0.05).

Conclusions: Although, EA patients had wider upper and lower esophageal segments than healthy peers, wider upper esophageal segment measurements did not significantly relate with OFD.

Keywords: esophageal atresia, tracheoesophageal atresia, oropharyngeal dysphagia, esophagus, children

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