Efficacy of Predicting Videofluoroscopic Results in Dysphagic Patients with Severe Cerebral Palsy Using the Mann Assessment of Swallowing Ability.

Abstract

The aim of this study was to evaluate the efficacy of the Mann Assessment of Swallowing Ability (MASA) to predict the results of videofluoroscopic swallowing studies. Children with cerebral palsy with suspicion of aspiration were enrolled. The Functional Dysphagia Scale (FDS) was used to quantify the swallowing dysfunction in videofluoroscopic swallowing studies. Correlation between MASA and FDS scores and differences in these two scores between aspirators and nonaspirators and between silent and overt aspirators were analyzed. Sixteen patients, level IV or V according the Gross Motor Function Classification System, were included. Thirteen patients (81.3%) had aspiration, and 9 (69.2%) were silent aspirators. The MASA scores between aspirators and nonaspirators were not different (median values of total scores, 107.0 and 94.0). The aspirators had higher FDS pharyngeal subtotal scores (P = 0.024) and slightly higher total FDS scores (P = 0.059). The differences in these two scales between silent and overt aspirators were not significant. Correlation coefficients between oral phase subtotal FDS scores and MASA subtotal scores in oral preparation, oral phase, and oral phase total were -0.713 (P < 0.05), -0.428 (P = 0.098), and -0.665 (P < 0.05), respectively. No correlation was found between the pharyngeal subtotal scores in these two scales. MASA was not useful in differentiating aspirators and nonaspirators and between silent and overt aspirators in severely disabled cerebral palsy, but it could predict oral dysfunction in videofluoroscopic swallowing studies.