Gastrostomy in treatment of neonats with dysphagia of neuromuscular origin

During last two years we have treated two neonates with dysphageal disorders in whom peroral nutrition was not possible because of aspirations at the same time. First patient had clinical appearance of Opitz-Frias, and another of Pierre-Robin syndrome. Dysphagia with aspirations in these neonats caused respiratory and general endanger with failure to thrive. General neurological status of these patients was good. Radiological and endoscopical examinations did not prove anatomical cause of dysphagic disorder with aspirations. Treatment was attempted with nutrition through nasogastric catheter, but because of gastric content regurgitation and vomiting, difficulties were not diminished. Parenteral support and nutrition was also carried out. In both patients gastrostomy was done, during the second month of life. Via gastrostomy good nutrition was enabled and patients gained body weight, while respiratory status was improved. In first patient deglutition matured during next nine month and further on he was feeded perorally without any difficulty. In second patient swallowing was disordered for longer period, so the gastrostomy catheter was removed after sixteen months, when peroral feeding became possible.Gastrostomy contributed in treatment of these patients, and showed advantage towards feeding through nasogastric tube and towards parenteral nutrition.