Translating High-Resolution Manometry From Research to Clinical Practice

2019 ◽  
Vol 4 (4) ◽  
pp. 641-647 ◽  
Author(s):  
Molly A. Knigge
Keyword(s):  
Clinical Practice ◽  
High Resolution ◽  
Upper Esophageal Sphincter ◽  
Speech Language Pathology ◽  
High Resolution Manometry ◽  
Sphincter Function ◽  
Speech Language Pathologist ◽  
Language Pathology ◽  
Esophageal Sphincter ◽  
Over Time

Purpose High-resolution manometry (HRM) is a developing evaluation and treatment modality within the scope of speech-language pathology clinical practice. HRM offers pressure measurement over time that can capture details of pharyngeal and upper esophageal sphincter function unattainable with current dysphagia imaging modalities. As the technology is being adapted from esophageal application to use in the pharynx, understanding the strengths and limitations of HRM is paramount to building valid models for clinical use. Conclusion This review of HRM translation from research to clinical practice aims to introduce the speech-language pathologist to this novel evaluation and treatment apparatus.

scholarly journals Physiological and pathological roles of the accommodation response in lower esophageal sphincter relaxation during wet swallows

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kazumasa Muta ◽  
Eikichi Ihara ◽  
Shohei Hamada ◽  
Hiroko Ikeda ◽  
Masafumi Wada ◽  
...  
Keyword(s):  
Clinical Practice ◽  
High Resolution ◽  
Observational Study ◽  
Lower Esophageal Sphincter ◽  
Relaxation Function ◽  
Esophagogastric Junction ◽  
Prospective Observational Study ◽  
Outflow Obstruction ◽  
High Resolution Manometry ◽  
Esophageal Sphincter

AbstractThe preparatory accommodation response of lower esophageal sphincter (LES) before swallowing is one of the mechanisms involved in LES relaxation during wet swallows, however, the physiological and/or pathological roles of LES accommodation remain to be determined in humans. To address this problem, we conducted a prospective observational study of 38 patients with normal high-resolution manometry (HRM) and 23 patients with idiopathic esophagogastric junction outflow obstruction (EGJOO) to assess dry and wet swallows. The LES accommodation measurement was proposed for practical use in evaluating the LES accommodation response. Although swallow-induced LES relaxation was observed in both dry and wet swallows, LES accommodation (6.4, 3.1–11.1 mmHg) was only observed in wet swallows. The extent of LES accommodation was impaired in idiopathic EGJOO (0.6, − 0.6–6 mmHg), and the LES accommodation measurement of patients with idiopathic EGJOO (36.8, 29.5–44.3 mmHg) was significantly higher in comparison to those with normal HRM (23.8, 18–28.6 mmHg). Successful LES relaxation in wet swallowing can be achieved by LES accommodation in combination with swallow-induced LES relaxation. Impaired LES accommodation is characteristic of idiopathic EGJOO. In addition to the IRP value, the LES accommodation measurement may be useful for evaluating the LES relaxation function in clinical practice.

The upper esophageal sphincter in the high-resolution manometry era

2021 ◽  
Author(s):  
Pedro Norton ◽  
Fernando A. M. Herbella ◽  
Francisco Schlottmann ◽  
Marco G. Patti
Keyword(s):  
High Resolution ◽  
Upper Esophageal Sphincter ◽  
High Resolution Manometry ◽  
Esophageal Sphincter

S118 – Study of Pharyngeal Swallowing by High-resolution Manometry

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P116-P117
Author(s):  
Kenji Takasaki ◽  
Umeki Hiroshi ◽  
Kaori Enatsu ◽  
Fujinobu Tanaka ◽  
Hidetaka Kumagami ◽  
...  
Keyword(s):  
High Resolution ◽  
Normal Values ◽  
Upper Esophageal Sphincter ◽  
Cervical Esophagus ◽  
High Resolution Manometry ◽  
Maximum Value ◽  
Physiological Information ◽  
Asymptomatic Adult ◽  
Esophageal Sphincter ◽  
Pharyngeal Swallowing

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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