Gambaran disfagia pada anak dan karakteristiknya

Abstract

Latar belakang: Disfagia pada anak merupakan kelainan yang sering ditemukan. Beberapa kelompok bayi dan anak dengan kelainan perkembangan dan/atau kondisi medis tertentu berisiko mengalami disfagia. Kondisi patologis yang melibatkan lokasi anatomi yang berperan dalam proses menelan, dapat berdampak negatif terhadap koordinasi fase-fase menelan. Hal ini dapat menimbulkan gejala disfagia ataupun kesulitan makan (feeding difficulties) yang akan berdampak buruk apabila tidak ditangani secara optimal. Tujuan: Mendapatkan gambaran tentang disfagia pada anak di Departemen Ilmu Penyakit Telinga Hidung Tenggorok - Bedah Kepala Leher Fakultas Kedokteran Universitas Indonesia, Rumah Sakit dr. Cipto Mangunkusumo. Metode: Studi deskriptif dengan desain potong lintang berdasarkan hasil pemeriksaan Flexible Endoscopic Evaluation of Swallowing (FEES) pada 19 pasien anak dengan disfagia. Data diambil dari status rekam medik pasien. Hasil: Didapatkan 7 feeding difficulties, 4 disfagia mekanik, 5 disfagia neurogenik, 1 disfagia campuran (disfagia mekanik dan neurogenik), 1 fungsi menelan normal sesuai usia, dan 1 disfagia neurogenik yang masih didiagnosis banding dengan disfagia mekanik fase esofageal dan feeding difficulties. Penyakit penyerta yang terbanyak adalah cerebral palsy, global delay development, hipertrofi tonsil dan adenoid, serta ensefalopati. Kesimpulan: Disfagia neurogenik pada anak paling banyak disebabkan oleh kelainan neurologik seperti cerebral palsy. Disfagia mekanik pada anak dapat disebabkan oleh hipertrofi tonsil dan adenoid.

Kata kunci: Anak, disfagia, feeding difficulties, flexible endoscopic evaluation of swallowing

ABSTRACT

Background: Dysphagia in the pediatric population are becoming more common. Certain groups of infants and children with specific developmental and/or medical conditions have been identified as being at high risk for developing dysphagia. If it does not managed properly, pathologic conditions involving any of the anatomic sites associated with the phases of swallowing can have negative impact on the coordination of these phases and lead to symptoms of dysphagia and feeding difficulties. Purpose: To obtain data in pediatric dysphagia in Otohinolaryngology-head and neck surgery, Medicine Faculty of Universitas Indonesia, dr. Cipto Mangunkusumo Hospital. Methods: A cross sectional and descriptive study of Flexible Endoscopic Evaluation of Swallowing (FEES) results in 19 pediatric patients with dysphagia. Data were collected from medical records. Results: Seven feeding difficulties, 4 mechanic dysphagia, 5 neurogenic dysphagia, 1 mixed (mechanic and neurogenic), 1 normal swallowing function and neurogenic dysphagia with the possibility of esophagea dysphagia. The comorbids were cerebral palsy, global delay development, adenoid-tonsil hypertrophy and ensephalopaty. Conclusion: The most common etiology of neurogenic dysphagia was cerebral palsy. Adenoid and tonsil hypertrophy were the common cause of mechanic dysphagia.

Keywords: Children, dysphagia, feeding difficulties, flexible endoscopic evaluation of swallowing