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

2006 ◽  
Vol 291 (3) ◽  
pp. G525-G531 ◽  
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.

scholarly journals NORMATIVE VALUES FOR A NEW WATER-PERFUSED HIGH RESOLUTION MANOMETRY SYSTEM

2018 ◽  
Vol 55 (suppl 1) ◽  
pp. 30-34 ◽  
Author(s):  
Rogério Mariotto Bitetti da SILVA ◽  
Fernando A M HERBELLA ◽  
Daniel GUALBERTO
Keyword(s):  
High Resolution ◽  
Low Cost ◽  
Upper Esophageal Sphincter ◽  
Normative Values ◽  
Residual Pressure ◽  
High Resolution Manometry ◽  
Pressure Transducers ◽  
Basal Pressure ◽  
Esophageal Sphincter ◽  
Body Parameters

ABSTRACT BACKGROUND: Esophageal manometry is the most reliable method to evaluate esophageal motility. High resolution manometry (HRM) provides topographic contour colored plots (Clouse Plots) with simultaneous analysis from the pharynx to the stomach. Both solid state and water-perfused systems are available. OBJECTIVE: This study aims to determinate the normative data for a new water-perfused HRM. METHODS: HRM was made in 32 healthy volunteers after 8 hours fasting. HRM system used consisted of a 24-channel water-perfused catheter (Multiplex, Alacer Biomedica, São Paulo, Brazil). The reusable catheter is made of polyvinyl chloride (PVC) with 4.7 mm of diameter. Side holes connected to pressure transducers are spaced 2 cm for the analysis from the pharynx to the lower esophageal sphincter (LES). Holes are spaced 5 mm and 120° in a spiral disposition in the LES area. The sensors encompass 34 cm in total. Upper esophageal sphincter (UES) parameters studied were basal and relaxation pressures. Esophageal body parameters were distal contractile integral (DCI), distal latency (DL) and break. LES parameters studied were basal pressure, integrated residual pressure (IRP), total and abdominal length. Variables are expressed as mean ± standard deviation, median (interquartile range) and percentiles 5-95th. RESULTS: All volunteers (17 males, aged 22-62 years) completed the study and tolerated the HRM procedure well. Percentiles 5-95th range were calculated: Upper Esophageal Sphincter (UES) basal pressure 16.7-184.37 (mmHg), DL: 6.2-9.1 (s), DCI: 82.72-3836.61 (mmHg.s.cm), break: <7.19 (cm), LES basal pressure: 4.89-37.16 (mmHg), IRP: 0.55-15.45 (mmHg). CONCLUSION: The performance and normative values obtained for this low-cost water-perfused HRM seems to be adequate for clinical use.

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

Sa1327 High-Resolution Manometry Assessment of the Lower-Esophageal Sphincter Aftercontraction: Normative Values and Clinical Significance

2016 ◽  
Vol 150 (4) ◽  
pp. S283-S284
Author(s):  
Dustin A. Carlson ◽  
Peter Kahrilas ◽  
Zoe Listernick ◽  
Yinglian Xiao ◽  
Vadim Bul ◽  
...  
Keyword(s):  
High Resolution ◽  
Lower Esophageal Sphincter ◽  
Clinical Significance ◽  
Normative Values ◽  
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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