Laryngeal penetration: a predictor of aspiration in infants?

Background. We routinely observed “isolated” laryngeal penetration (ILP) on upper GI studies in infants with no risk for aspiration. Objective. To determine whether “isolated” LP (LP during the pharyngeal phase of swallowing) is a benign process in infants and therefore not a predictor of aspiration as it is known to be in adults. Patients and methods. Two radiologists retrospectively reviewed videotaped upper GI studies done over a 2-year period on patients less than 2 years of age. A total of 110 studies was reviewed, which produced a study group of 34 patients who had no history or clinical suspicion for swallowing dysfunction. Results. Of the 34 patients in the group, 33 demonstrated ILP without radiographic or clinical evidence of aspiration. Conclusion. ILP is a benign, normal process in infants likely due to immaturity of the swallowing mechanism. It is not a reliable predictor of aspiration as it is in adults.