Ahmed, S.A.A.E., Abdelgoad, A.A. & Khaled, D.M.F. The efficacy of 3-ounce water swallow test as a screening tool for dysphagic children: a study in a tertiary hospital. Egypt J Otolaryngol 40, 175 (2024). https://doi.org/10.1186/s43163-024-00729-8
This is an open access article that I want to share on the use of the 3 ounce water test for children. Authors are recommending that it may be helpful in conjunction with an instrumental study. Always glad to see continued research in pediatric swallowing!
Ahmed, S.A.A.E., Abdelgoad, A.A. & Khaled, D.M.F. The efficacy of 3-ounce water swallow test as a screening tool for dysphagic children: a study in a tertiary hospital. Egypt J Otolaryngol 40, 175 (2024). https://doi.org/10.1186/s43163-024-00729-8
Abstract
Background In children, oropharyngeal dysphagia increases the risk of aspiration, pneumonia, and even mortality. It has been demonstrated that dysphagia screening improves health outcomes. The purpose of the study is to inves- tigate the clinical value of the 3-oz water swallow test for detecting aspiration risk and the possibility for oral feeding in children and determine whether it is a suitable tool for identifying swallowing issues.
Method This study included 90 children with dysphagia: 48 boys and 42 girls, aged 2–12 years old with an average age of 6.2 ± 2.3 years, and 80% of them were older than 3 years. Sixty percent were orally fed, while 40% were on mod- ified oral feeding. More than half the children (53.3%) had dysphagia for more than 1 week. All study participants underwent 3-oz water swallow test and flexible endoscopic evaluation of swallowing test consecutively.
Results The flexible endoscopic evaluation of swallowing revealed 42 positive cases (46.7%) and 48 negative (53.3%). The 3-oz water swallow test yielded 39 positive cases (i.e., failed) and 51 negatives (i.e., passed the test), with no sta- tistically significant difference from the flexible endoscopic evaluation of swallowing test results (p = 0.701). There were no statistically significant differences between positive and negative cases regarding their age, gender, or mode of feeding. However, positive cases had significantly longer duration of dysphagia than negative cases (p = 0.001). The best-fit model (3-oz water swallow test model) includes the following: the 3-oz water swallow test result, age, gender, and the dysphagia duration. This model accurately identified aspiration risk among dysphagic children in 76.7% com- pared to 70.0% by the 3-oz water swallow test alone.
Conclusion and recommendations
The bedside water swallow test (3-OWS) is not as strong and powerful enough as the FEES and videofluoroscopic modified barium swallow (MBS) to be used as a screen- ing tool in pediatric population. FEES was recommended with the use of 3-OWS test in children with dysphagia especially children below 3 years old and complaining of dysphagia for 1–6 days duration, with a well-trained, good observer clinician who will be ready for any complications in order to be able to take the best and safest decision to the patient.
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