Neonatal Esophagus and Airway Interaction in Health and Disease

在婴儿人群中，吞咽困难和吞咽的复杂问题仍然是一个难题， 这一人群的护理管理。缺乏病理生理学指导的诊断和安全 喂养管理战略仍然是这一领域取得进展的关键障碍。这项建议会 重点关注新生儿咽部、食管上段、食管下段和食管下段的综合生理动态变化， 吞咽和胃食管反流病期间的括约肌（UES）、食管下括约肌（LES）和食管。的 该项目的总体目标是研究治疗婴儿吞咽困难的新方法。 该项目将实现两个目标。 目的1：两种喂养策略对吞咽困难患者临床、安全性和经济结局的有效性 婴儿顺行性吸入。 该目标的目的是开发新的喂养策略，以改善临床结果，并阐明 经口喂养的婴儿（6个月以下）的呼吸消化保护机制， 通过诊断视频荧光检查吞咽研究（VFSS）。 目的2：喂养策略对咽和食管敏感性的机制和影响 吞咽困难伴或不伴GERD的呼吸消化反射。 本目标的目的是通过检查感觉运动来区分GERD及其后果。 吞咽的特征、各种反射和使用测压研究的呼吸消化协调。

In the infant population, the complex issues of dysphagia and swallowing remain to be a conundrum when it comes to the care management of this population. The lack of a pathophysiology guided diagnostic and safe feeding management strategies continue to be critical barriers to progress in this field. This proposal will focus on the dynamic changes in the integrative physiology of the neonatal pharynx, upper esophageal sphincter (UES), lower esophageal sphincter (LES) and esophagus during swallowing and GERD. The overall goal of this project is to examine new management approaches of dysphagia in the infant population. This project will address two aims. Aim 1: Effectiveness of two feeding strategies on clinical-, safety- and economic- outcomes in dysphagic infants with anterograde aspiration. The goal of this Aim is to develop novel feeding strategies, to improve clinical outcomes and to clarify aerodigestive protective mechanisms in oral-fed infants (under 6 months of age) with abnormalities proven by diagnostic video fluroscopy swallow study (VFSS). Aim 2: Mechanisms and Impact of feeding strategies on pharyngeal and esophageal sensitivity of aerodigestive reflexes in dysphagia with or without GERD. The goal of this Aim is to differentiate GERD and its consequences by examining the sensory-motor characteristics of the swallow, various reflexes and aero-digestive coordination using manometric studies.