768 - Unanticipated anatomical abnormalities reported in preterm infants with Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

To describe the anatomical findings observed under FEES evaluation and evaluate the rates of subspecialist referral or facility transfer based upon these findings.

Design/Methods:

Retrospective chart review of 83 infants born in 2018-2022 and who received FEES evaluation. FEES reports were reviewed for findings concerning of anatomical variation or laryngomalacia. The rate of SLP recommendations for ENT evaluation was tracked. The outcomes after findings of anatomical variation or laryngomalacia (observation vs. transfer etc.) were described.

Results:

A total of 83 premature infants with mean birth gestational age of 32.11 weeks were included with mean corrected gestational age of 39.27 weeks at time of exam. 25 infants were noted to have findings concerning for laryngomalacia on FEES.  Additionally, 10 infants were reported to have other anatomic abnormalities including vocal cord abnormalities in 5 infants and epiglottic abnormalities in 3 infants, sub glottic stenosis and narrow nasal passage in the remaining two patients.  Four infants were emergently transferred to a quaternary care center for further evaluation and interventions. Description of infants transferred and requiring interventions are displayed in Table 1.

Conclusion(s):

We report 42% of our infants undergoing FEES procedure for evaluation of swallow discoordination or aspiration as suspected to have anatomical abnormalities with laryngomalacia being the most common abnormality and 7% of infants requiring urgent transfer for subspecialist evaluation and treatment. Further large studies are needed to evaluate the utility of FEES in identifying anatomical abnormalities in addition to swallow disorders.