Investigation of Pharyngeal Swallowing Function Using High-Resolution Manometry

Purpose. We evaluated the intra- and interrater agreement and test-retest reliability of analyst derivation of swallow function variables based on repeated high resolution manometry with impedance measurements.Methods. Five subjects swallowed10×10 mL saline on two occasions one week apart producing a database of 100 swallows. Swallows were repeat-analysed by six observers using software. Swallow variables were indicative of contractility, intrabolus pressure, and flow timing.Results. The average intraclass correlation coefficients (ICC) for intra- and interrater comparisons of all variable means showedsubstantialtoexcellentagreement (intrarater ICC 0.85–1.00; mean interrater ICC 0.77–1.00). Test-retest results were less reliable. ICC for test-retest comparisons ranged fromslighttoexcellentdepending on the class of variable. Contractility variables differed most in terms of test-retest reliability. Amongst contractility variables, UES basal pressure showedexcellenttest-retest agreement (mean ICC 0.94), measures of UES postrelaxation contractile pressure showedmoderatetosubstantialtest-retest agreement (mean Interrater ICC 0.47–0.67), and test-retest agreement of pharyngeal contractile pressure ranged fromslighttosubstantial(mean Interrater ICC 0.15–0.61).Conclusions. Test-retest reliability of HRIM measures depends on the class of variable. Measures of bolus distension pressure and flow timing appear to be more test-retest reliable than measures of contractility.

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S118 – Study of Pharyngeal Swallowing by High-resolution Manometry

Otolaryngology ◽

10.1016/j.otohns.2008.05.291 ◽

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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Quantitative Analysis of Swallowing Function Between Dysphagia Patients and Healthy Subjects Using High-Resolution Manometry

Annals of Rehabilitation Medicine ◽

10.5535/arm.2017.41.5.776 ◽

2017 ◽

Vol 41 (5) ◽

pp. 776 ◽

Cited By ~ 7

Author(s):

Chul-Hyun Park ◽

Don-Kyu Kim ◽

Yong-Taek Lee ◽

Youbin Yi ◽

Jung-Sang Lee ◽

...

Keyword(s):

Quantitative Analysis ◽

High Resolution ◽

Healthy Subjects ◽

Swallowing Function ◽

High Resolution Manometry

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

Physiology & Behavior ◽

10.1016/j.physbeh.2014.01.030 ◽

2014 ◽

Vol 128 ◽

pp. 46-51 ◽

Cited By ~ 23

Author(s):

Tuo Lin ◽

Guangqing Xu ◽

Zulin Dou ◽

Yue Lan ◽

Fan Yu ◽

...

Keyword(s):

High Resolution ◽

Bolus Volume ◽

High Resolution Manometry ◽

Pharyngeal Swallowing

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Evaluation of pharyngeal swallowing pressure using high-resolution manometry during transoral surgery for oropharyngeal cancer

The Journal of Laryngology & Otology ◽

10.1017/s0022215121000311 ◽

2021 ◽

Vol 135 (2) ◽

pp. 153-158

Author(s):

K Fujiwara ◽

S Koyama ◽

K Taira ◽

K Kawamoto ◽

T Fukuhara ◽

...

Keyword(s):

High Resolution ◽

Oropharyngeal Cancer ◽

Objective Evaluation ◽

Transoral Surgery ◽

Swallowing Function ◽

High Resolution Manometry ◽

Pharyngeal Pressure ◽

Significant Difference ◽

Upper Oesophageal Sphincter ◽

The Impact

AbstractBackgroundTransoral robotic surgery is frequently described, driven by the desire to offer a less morbid alternative to chemoradiation. However, the objective evaluation of post-operative function has rarely been reported. Therefore, high-resolution manometry was used in this study to evaluate the impact of changes in peri-operative swallowing function on pharyngeal pressure events.MethodsTen patients with various stages of oropharyngeal cancer underwent transoral surgery. High-resolution manometry and videofluoroscopic swallow studies were performed before surgery and two months afterwards. The following parameters were obtained: velopharyngeal and mesopharyngeal post-deglutitive upper oesophageal sphincter pressures, velo-meso-hypopharyngeal contractile integral, upper oesophageal sphincter relaxation pressure, and pharyngeal velocity.ResultsThere was no significant difference in pharyngeal pressure or contractile integral pre- versus post-operatively. However, pharyngeal velocity was significantly higher post-operatively than pre-operatively.ConclusionHigh-resolution manometry showed that transoral surgery in patients without pre-operative dysphagia preserved pharyngeal constriction. However, transoral surgery might produce scar formation in the pharynx, which could lead to narrowing of the pharynx.

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