Abstract
Introduction Feeding problems are common in children with esophageal atresia and tracheoesophageal
fistula (EA–TEF); however, chewing disorders, which may cause inability to intake
solid food, have not been evaluated. Therefore, we aimed to evaluate the chewing function
in children with repaired EA–TEF.
Materials and Methods Age, sex, the type of atresia, the type of repair, and the time to start oral feeding
were recorded. The level of the chewing performance was scored according to the Karaduman
Chewing Performance Scale (KCPS). The International Dysphagia Diet Standardization
Initiative (IDDSI) was used to determine the tolerated food texture in children.
Results A group of 30 patients were included, of which 53.3% was male. The percentages of
the isolated-EA and that of the EA–distal TEF were 40% and 60%, respectively. The
median value for the time to start oral feeding was 4.5 weeks (min = 1, max = 72).
Eleven (36.7%) children had chewing disorder. The KCPS scores showed level I in six
cases, level III in four cases, and level IV in one case. Five children with chewing
disorder had IDDSI level 3 and six had level 7, along with the sensation of stuck
food. We found no significant difference between the KCPS scores according to the
repair type (p = 0.07). The median values of the KCPS scores of children with primary repair, delayed
repair, and colon interposition were 0 (min = 0, max = 4), 0.5 (min = 0, max = 3),
2 (min = 0, max = 3), respectively. A significant positive correlation was found between
the time to start oral feeding and the KCPS scores (r = 0.63, p = 0.001).
Conclusion Chewing disorders can be observed in children with EA–TEF, and the type of repair
and the delay in oral feeding may be related to chewing disorder. Therapeutic maneuvers
are needed to improve the chewing function in children with EA–TEF.
Keywords
esophageal atresia - tracheoesophageal fistula - chewing disorders - chewing function
