Table 2.

A typical case of patient underwent clinical swallowing evaluation (CSE) program

Items	Before the operation (1–7 mon)	Perioperative period (7 mon 7 d–7 mon 23 d)	After the operation (8–24 mon)
Evaluation of eating skills	Parenteral nutrition for nutritional support Enteral nutrition support through gastrostomy (tube feeding)	Enteral nutrition support through gastrostomy (tube feeding)	Maintenance of gastrostomy for a duration of one to two months
	The insertion of a salivary drainage tube into the oral cavity induces a state of oral sensory aversion	Improved oral sensory function Reduced oral suction capacity Delayed motor development	The aim was to preserve oral function
Screening for potential risk factors	Moist sounds in the pharyngeal region, improved by vertical positioning of the head	Inability to sit alone	X-ray imaging to confirm postoperative esophageal function is a prerequisite for safe oral feeding
Intervention	A salivary drainage tube is introduced through the nasal cavity to minimize oral discomfort Exercise through false sucking and oral training Facilitate mother–child dyadic interaction by encouraging eye contact and lip stimulation (Fig. 1a) Prepare for oral feeding Physical rehabilitation to improve trunk stability Regular application of CSE, such as hand-mouth and hand-object-mouth exercises Referral to the otolaryngology department to exclude tracheomalacia	Introduce airless bottle suction practice before surgery to prepare for postoperative oral feeding (Fig. 1b) Referral to a specialized nursing team for caregiver education on gastrostomy care	Prior to oral feeding, the child must practice swallowing water. After swallowing 5 ml of water proficiently, oral feeding of special formula milk is started. In 3 days, full oral feeding is achieved Follow-up at 2 years of age and continue regular CSE to help introduce solid foods, food diversity, and guide responsive feeding to promote early development in children (Fig. 1c)

We report one case to illustrate CSE for patients who undergo surgical anastomosis for long-gap esophageal atresia (Fig. 1). Intrauterine ultrasound at 33 weeks of pregnancy indicated that stomach bubble was not present. At 38 + 3 days of pregnancy, the patient underwent a cesarean section, and the male infant’s birth weight was 2900 g. On the day of birth, congenital esophageal atresia (type I) was diagnosed through laparoscopic gastrostomy and distal esophagography. Given that the distance between the two ends of the esophagus was 7.5 cm, the infant had a longer waiting period for surgery and was tube-fed during this time. Surgical anastomosis was performed at the age of 7 months and 23 days. After several rounds of pre- and postoperative CSE, the infant achieved full oral feeding at 8 months of age, 17 days after undergoing surgical anastomosis