Effect of bolus volume on pharyngeal swallowing assessed by high-resolution manometry

Objectives This study aimed to demonstrate the feasibility of a novel high-resolution manometry (HRM) system, and to establish normal values of swallowing pressures along the velopharynx and upper esophagus. Methods 33 asymptomatic adult Japanese controls were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1 cm apart was positioned to record pressures during swallowing from the velopharynx to the upper esophagus. The maximum values of the swallowing (dry and 5 ml of water) pressures at velo, meso-hypopharynx, and at the upper esophageal sphincter (UES) were measured. The resting UES pressure, the length of the part in the cervical esophagus showing the resting UES pressure, and the distance from the nostril to the above-mentioned points of pressure were also measured. Results The maximum value of dry and water swallowing pressures at the velopharynx, meso-hypopharynx and UES, and the distances from the nasal vestibulum to each point were 132.3±61.3 (mmHg, mean ± standard deviation), and 146.5±77.5, 171.6±52.0, and 176.3±74.4, 163.5±70.6, and 239.3±80.1, and 9.8±1.2 (cm), and 9.8±1.3, 13.6±1.6, and 13.7±1.5, 17.0±1.9 and 17.1±1.6, respectively. The maximum value of the resting USE pressure, the length of the part in the cervical esophagus showing the resting USE pressure, and the distance from the nostril to the mid-point of the length of the resting UES pressure were 66.6±28.1 mmHg, 3.8±0.7 cm, and 18.2±1.6 cm, respectively. Conclusions The present study provides anatomical and physiological information about normal swallowing along the velopharynx and upper esophagus, which will be an aid to future clinical and investigative studies.

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Age-Related Functional Reserve Decline Is Not Seen in Pharyngeal Swallowing Pressures

Journal of Speech Language and Hearing Research ◽

10.1044/2021_jslhr-21-00164 ◽

2021 ◽

pp. 1-8

Author(s):

Corinne A. Jones ◽

Christina M. Colletti

Keyword(s):

High Resolution ◽

Repeated Measures ◽

Tongue Pressure ◽

Maximum Output ◽

Older Individuals ◽

Healthy Individuals ◽

Functional Reserve ◽

High Resolution Manometry ◽

Age Related ◽

Pharyngeal Swallowing

Purpose Functional reserve represents the difference between an individual's ability to produce a maximum output function and the ability to perform a functional task. Several studies have documented an age-related decrease in functional reserve with oral tongue pressure generation. Whether this pattern is seen in pharyngeal swallowing pressures is unknown. The aim of this study was to investigate pharyngeal functional reserve using high-resolution manometry during normal-effort and effortful swallows. Method Pharyngeal high-resolution manometry was performed on 38 younger healthy individuals (≤ 40 years) and 18 older healthy individuals (≥ 60 years) during normal-effort and effortful water swallows. Pressure metrics included maximum pressure in the velopharynx, tongue base, and hypopharynx, as well as pharyngeal contractile integral and minimum pressure in the upper esophageal sphincter (UES). Repeated-measures analysis of variance was used to determine the effects of swallow task, age, and pharyngeal region on pressure generation. Results Maximum pharyngeal pressures and pharyngeal contractile integral were significantly increased during the effortful swallows compared to normal-effort swallows ( p < .001), but there were no interactions between task and age in pharyngeal pressures. In the UES, minimum pressures were significantly elevated in older individuals during effortful swallows compared to normal-effort swallows ( p = .007) but did not follow a pattern consistent with reduced functional reserve. Conclusions Healthy individuals increase pharyngeal driving pressures during effortful swallows, without an age-related reduction in the magnitude of pressure increase. Thus, this study did not find evidence for an age-related reduction in pharyngeal functional reserve. The preserved ability to increase pharyngeal pressures during effortful swallowing in aging may support the use of behavioral swallowing interventions in older individuals without neuromuscular conditions. Supplemental Material https://doi.org/10.23641/asha.16606709

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Investigation of Pharyngeal Swallowing Function Using High-Resolution Manometry

The Laryngoscope ◽

10.1097/mlg.0b013e31817dfd02 ◽

2008 ◽

Vol 118 (10) ◽

pp. 1729-1732 ◽

Cited By ~ 54

Author(s):

Kenji Takasaki ◽

Hiroshi Umeki ◽

Kaori Enatsu ◽

Fujinobu Tanaka ◽

Noriyuki Sakihama ◽

...

Keyword(s):

High Resolution ◽

Swallowing Function ◽

High Resolution Manometry ◽

Pharyngeal Swallowing

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The Effects of Bolus Volume and Texture on Pharyngeal Pressure Events Using High-resolution Manometry and Its Comparison with Videofluoroscopic Swallowing Study

Journal of Neurogastroenterology and Motility ◽

10.5056/jnm15095 ◽

2016 ◽

Vol 22 (2) ◽

pp. 231-239 ◽

Cited By ~ 11

Author(s):

Ju Seok Ryu ◽

Donghwi Park ◽

Yoongul Oh ◽

Seok Tae Lee ◽

Jin Young Kang

Keyword(s):

High Resolution ◽

Bolus Volume ◽

Videofluoroscopic Swallowing Study ◽

High Resolution Manometry ◽

Pharyngeal Pressure

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Pharyngeal swallow adaptations to bolus volume measured with high-resolution manometry

The Laryngoscope ◽

10.1002/lary.21150 ◽

2010 ◽

Vol 120 (12) ◽

pp. 2367-2373 ◽

Cited By ~ 77

Author(s):

Matthew R. Hoffman ◽

Michelle R. Ciucci ◽

Jason D. Mielens ◽

Jack J. Jiang ◽

Timothy M. McCulloch

Keyword(s):

High Resolution ◽

Bolus Volume ◽

High Resolution Manometry ◽

Pharyngeal Swallow

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Deglutitive upper esophageal sphincter relaxation: a study of 75 volunteer subjects using solid-state high-resolution manometry

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00081.2006 ◽

2006 ◽

Vol 291 (3) ◽

pp. G525-G531 ◽

Cited By ~ 119

Author(s):

Sudip K. Ghosh ◽

John E. Pandolfino ◽

Qing Zhang ◽

Andrew Jarosz ◽

Peter J. Kahrilas

Keyword(s):

Solid State ◽

High Resolution ◽

Detailed Analysis ◽

Automated Analysis ◽

Upper Esophageal Sphincter ◽

Normative Values ◽

Bolus Volume ◽

High Resolution Manometry ◽

Pressure Profiles ◽

Esophageal Sphincter

This study aimed to use a novel high-resolution manometry (HRM) system to establish normative values for deglutitive upper esophageal sphincter (UES) relaxation. Seventy-five asymptomatic controls were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1 cm apart was positioned to record from the hypopharynx to the stomach. Subjects performed ten 5-ml water swallows and one each of 1-, 10-, and 20-ml volume swallows. Pressure profiles across the UES were analyzed using customized computational algorithms that measured 1) the relaxation interval (RI), 2) the median intrabolus pressure (mIBP) during the RI, and 3) the deglutitive sphincter resistance (DSR) defined as mIBP/RI. The automated analysis succeeded in confirming bolus volume modulation of both the RI and the mIBP with the mean RI ranging from 0.32 to 0.50 s and mIBP ranging from 5.93 to 13.80 mmHg for 1- and 20-ml swallows, respectively. DSR was relatively independent of bolus volume. Peak pharyngeal contraction during the return to the resting state postswallow was almost 300 mmHg, again independent of bolus volume. We performed a detailed analysis of deglutitive UES relaxation with a novel HRM system and customized software. The enhanced spatial resolution of HRM allows for the accurate, automated assessment of UES relaxation and intrabolus pressure characteristics, in both cases confirming the volume-dependent effects and absolute values of these parameters previously demonstrated by detailed analysis of concurrent manometry/fluoroscopy data. Normative values were established to aid in future clinical and investigative studies.

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