Evaluation of swallowing disorders in children.

Congenital anomalies of the head and neck and congenital and acquired neuromuscular disorders in children are frequently associated with dysfunctional feeding and swallowing. Determination of the affected phase of swallowing and appropriate guidelines for feeding depend on detailed clinical assessment at the bedside and radiographic evaluation by videofluoroscopy. Fiberoptic and rigid endoscopic examination of the airway are useful in the diagnosis of subtle structural abnormalities that are not appreciated on physical and radiologic examination. Once a diagnosis is established, repeating the evaluation process helps to assess the outcome of therapeutic and surgical intervention.