2015, Number 3
Safety and efficacy of swallowing evaluated by the method of clinical volume-viscosity (MECV-V) assessment and its association with nutritional status in children with lip and/or cleft palate
Ortiz-Madrigal MJ, Márquez-Ávila CS, Ibarra-Grajeda D, Villalpando-Carrión S, Olvera-Gómez JL
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Language: Spanish
References: 13
Page: 95-102
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ABSTRACT
Introduction: The lip and/or cleft palate (LCP) is the most common orofacial malformation; The associated complications include swallowing disorders. Objective: To describe by clinical evaluation method of volume-viscosity (MECV-V) the findings in swallowing of LCP minors and its relation to their nutritional status. Material and methods: Cross-sectional study. Pediatric patients of the Pediatric Phoniatrics Service of the Mexico "Federico Gomez" Pediatric Hospital between 2 and 17 years of age with surgically corrected LCP. The phoniatrics clinical history was made, anthropometry, the questionnaire "Subjective Global Assessment nutrition in children" (SGNA) was answered, the MECV-V and a complete blood count was requested. Results: 40 patients were included. 40% (16) were female and 60% (24) male, between 2 and 16 years old with a mean of 7 years 2 months ± 3.28. Submucosal cleft palate (SMCP) was found in 12 patients (30%), right LCP in 11 (27.5%), left LCP in 8 (20%). Anthropometry: weight for age in ‹ 10 years (32): regular in 29 (90.6%) and 3 (9.4%) had low weight. Normal size for age in 33 (82.5%) and 7 (17.5%) with low height. Normal BMI for age, except in one patient (2.5%) ‹ 2 SD. Complete blood count regular in 35 patients and one patient (2.8%) with anemia. SGNA questionnaire 100% regular. MECV-V: efficacy of the oral swallowing; oral residue 34 (85%), failure of lip seal 17 (42.5%) and fractional swallowing 11 (27.5%). Safety: O2 desaturation in 4 (10%). A moderate correlation was found between the average age with serum hemoglobin (r = 0.47; p = 0.002; Spearman) and slight correlation with body mass index (r = 0.29; p = 0.031; Spearman); correlation coefficient Eta (η) showed that adequate swallowing explained 84.8% of the variation of hemoglobin levels, 80.8% of the variation in weight, 80.4% of the variation in size and 78.1% changes in BMI. The effectiveness (oral and pharyngeal) shows low percentages of variation in hemoglobin (14.9%), weight (9.3%), height (12.2%) and BMI (11.8%). Conclusions: Swallowing disorders are underdiagnosed. No nutritional alterations were found. The MECV-V method is a useful and simple screening method for evaluating swallowing.REFERENCES
González-Osorio CA, Medina-Solís CE, Pontigo-Loyola AP, Casanova-Rosado JF, Escoffié-Ramírez M, Corona-Tabares MG et al. Estudio ecológico en México (2003-2009) sobre labio y/o paladar hendido y factores sociodemográficos, socioeconómicos y de contaminación asociados. An Pediatr (Barc). 2011; 74 (6): 377-387.