The Utility of High-Resolution Pharyngeal Manometry in Dysphagia Treatment

Purpose High-resolution pharyngeal manometry (HRPM) is an emerging technology that shows promise as both an adjuvant diagnostic and therapeutic tool in oropharyngeal dysphagia management. Advances in manometric technology, including increased number of sensors and topographical pressure plots, enhance the biofeedback potential for the pharynx. This clinical focus article serves as an overview of the utility of HRPM in dysphagia treatment. Conclusion HRPM-facilitated biofeedback aids the patient in the correct implementation of clinical recommendations and also provides the clinician an assessment of the effectiveness and accuracy of those targeted interventions. Topographic pressure plots provide intuitive feedback, allow easier swallow-to-swallow comparisons, and produce visually color-coded pressure information for the patient and clinician in real time. Paired with existing, evidence-based interventions, HRPM biofeedback may facilitate maneuver and strategy planning, exercise training and monitoring, temporal coordination, upper esophageal segment relaxation and duration, swallow mapping (topographic pattern recognition and approximation), fatigue monitoring, dose planning, adherence tracking, and efficacy assessment of selected interventions. Although competency training is needed to effectively utilize HRPM, there are growing opportunities for the speech-language pathologist to acquire and implement this technology for the benefit of patients.