Abstract â–¡ 173

Feeding and breathing in infants are intimately combined. Infants with disordered breathing may present with feeding difficulties. Patients with cleft palate or craniofacial anomalies may present a special therapeutic challenge. The variable anatomy is responsible for the different upper respiratory tract behaviour in both breathing and feeding. Abnormalities of craniofacial anatomy such as cleft palate, dorsally rotated tongue, increased tongue volume, dorsocaudal location of the hyoid bone, obtuse gonial angle with retruded mandible and decreased flexure of the cranial base are all morphological deviations that characterise patients prone to develop breathing and feeding problems. Infants with feeding difficulties are usually treated on clinical base. However, sometimes the attempted feeding procedures including different bottles and nipples failed, leading to increased length of time in the feeding process and inadequate weight gain. These infants may be cured if the anatomic features, which predispose to the development of these problems, are isolated and defined and their breathing and feeding mechanisms are well understood. Videofluoroscopy is a powerful technique for studying the pathogenic mechanisms of feeding problems. Videofluoroscopy allows understanding of the underlying biomechanics and also allows design and evaluation of the efficacy of treatment options in these patients. Breathing and feeding disorders during the growing process has detrimental effects on child development and even risks his life. Skilled assessment and management early in life are mandatory. Videofluoroscopic tapes of various cases will be presented and discussed.