Clinical feeding examination with cervical auscultation for detecting oropharyngeal aspiration: A systematic review of the evidence

被引：7

作者：

Frakking, Thuy T. ^{[1
,2
,3
]}

Chang, Anne B. ^{[4
,5
,6
]}

David, Michael ^{[7
]}

Orbell-Smith, Jane ^{[8
]}

Weir, Kelly A. ^{[9
,10
]}

机构：

[1] Caboolture Hosp, Metro North Hosp & Hlth Serv, Speech Pathol Dept, Queensland Hlth, Caboolture, Qld, Australia

[2] Caboolture Hosp, Metro North Hosp & Hlth Serv, Res Dev Unit, Queensland Hlth, Caboolture, Qld, Australia

[3] Univ Queensland, Sch Hlth & Rehabil Sci, St Lucia, Qld, Australia

[4] Queensland Childrens Hosp, Dept Resp Med, Brisbane, Qld, Australia

[5] Charles Darwin Univ, Menzies Sch Hlth Res, Child Hlth Div, Casuarina, NT, Australia

[6] Queensland Univ Technol, Ctr Childrens Hlth Res, Brisbane, Qld, Australia

[7] Univ Newcastle, Sch Med & Publ Hlth, Gosford, NSW, Australia

[8] Caboolture Hosp, Metro North Hosp & Hlth Serv, Lib Serv, Caboolture, Qld, Australia

[9] Griffith Univ, Menzies Hlth Inst Queensland, Sch Allied Hlth Sci, Brisbane, Qld, Australia

[10] Gold Coast Univ Hosp, Educ & Res, Clin Governance, Southport, Qld, Australia

来源：

CLINICAL OTOLARYNGOLOGY | 2019年 / 44卷 / 06期

基金：

英国医学研究理事会;

关键词：

cervical auscultation; child; deglutition; deglutition disorders; oropharyngeal aspiration; systematic review; FIBEROPTIC ENDOSCOPIC EVALUATION; CHILDREN; DYSPHAGIA; DIAGNOSIS; SOUNDS; ADULTS; COUGH;

D O I：

10.1111/coa.13402

中图分类号：

R76 [耳鼻咽喉科学];

学科分类号：

100213 ;

摘要：

Background Cervical auscultation (i.e. listening to swallowing sounds) is the most commonly used technique in adjuvant to the clinical feeding examination by speech-language pathologists worldwide to assess for oropharyngeal aspiration risk in children. Despite its relative popularity in clinical practice, little is known on the clinical utility of cervical auscultation within a paediatric population. Objective To determine the diagnostic test accuracy of the clinical feeding examination with cervical auscultation in the detection of aspiration in children. Type of review Narrative review. Prospero Registration: CRD42017081467 Search strategy: Medline/Pub Med, Embase, CINAHL, AustHealth, Cochrane and UQ (Scopus) were searched up until October 2017. Specifically, the search terms used were: (((oropharyngeal OR respiratory) aspiration) AND (child* OR pediatr* OR paediatr*) and (cervical auscultation OR swallow sounds OR swallowing sounds OR accelerometry OR swallowing acoustics)). The search strategy also included scanning reference lists and citations of retrieved studies. Evaluation method Extracted studies were reviewed by two independent reviewers. Methodological quality of studies was assessed using the QUADAS-2 tool. Results Only one study met inclusion criteria for this review, which had a bias for flow and timing. Use of cervical auscultation in conjunction with the clinical feeding examination to predict aspiration had a positive predictor value (PPV) of only 0.49 (0.31-0.66), indicating potential over-prediction of aspiration when cervical auscultation is used. In contrast a high NPV of 0.92 (0.78-0.98) was reported indicating that cervical auscultation is useful at ruling out aspiration in children. Conclusion This review highlights the paucity of research studies assessing the accuracy of cervical auscultation as an adjuvant to the clinical feeding examination in aspiration detection within the paediatric population.

引用

页码：927 / 934

页数：8

共 46 条

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