Influence of mucosal receptors on deglutitive regulation of pharyngeal and upper esophageal sphincter function

The potential influence of mucosal sensory receptors on the regulation of oral-pharyngeal swallow events was studied in 15 healthy volunteers using simultaneous videoradiography and manometry. We determined the effects of selective pharyngeal and oral plus pharyngeal anesthesia on the following temporal and manometric measures in response to liquid and viscous swallows: regional transit and clearance times; motion of hyoid and larynx; upper esophageal sphincter relaxation, opening, and closure; and pharyngeal contraction wave characteristics. Under the influence of mucosal anesthesia no subjects demonstrated aspiration during deglutition. Neither regional transit and clearance times nor pharyngosphincteric coordination was influenced significantly by pharyngeal mucosal anesthesia or oral plus pharyngeal anesthesia. Although midpharyngeal and distal pharyngeal contraction amplitudes were not influenced by mucosal anesthesia, midpharyngeal contraction wave duration was reduced significantly by both pharyngeal (P = 0.02) and oral plus pharyngeal anesthesia (P = 0.0005). We conclude that 1) neither elicitation of the pharyngeal swallow response nor temporal regulation among swallow events is dependent on mucosal sensory receptors and 2) duration of the pharyngeal contraction is influenced by sensory input from the oral-pharyngeal mucosa.

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Influence of normal aging on oral-pharyngeal and upper esophageal sphincter function during swallowing

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1995.268.3.g389 ◽

1995 ◽

Vol 268 (3) ◽

pp. G389-G396 ◽

Cited By ~ 24

Author(s):

D. W. Shaw ◽

I. J. Cook ◽

M. Gabb ◽

R. H. Holloway ◽

M. E. Simula ◽

...

Keyword(s):

The Elderly ◽

Normal Aging ◽

Upper Esophageal Sphincter ◽

Flow Rates ◽

Elderly Individuals ◽

Sphincter Function ◽

Pharyngeal Swallow ◽

Esophageal Sphincter ◽

Ues Opening ◽

Pharyngeal Swallowing

The influence of aging on oral-pharyngeal swallowing was assessed by simultaneous manometry and videoradiography in 14 nondysphagic elderly individuals (mean age 76 yr) and 11 healthy, young controls (mean age 21 yr). Sphincter opening was diminished significantly in the elderly (P = 0.0001), but trans-sphincteric bolus flow rates were preserved. The increased impedance to trans-sphincteric bolus flow from reduced sphincter opening in the aged was reflected in a significant increase in hypopharyngeal intrabolus pressure (P = 0.003). Oral transit time was significantly prolonged in the aged (P = 0.01). The timing of upper esophageal sphincter (UES) manometric relaxation and of opening was significantly delayed in the aged (P = 0.0001), and this delay was comparable in magnitude to the prolongation in oral transit. Coordination of UES relaxation and opening with midpharyngeal contraction was not significantly affected by age. Deglutitive hyolaryngeal motion was not affected by age but was delayed by a duration equivalent to the prolongation in oral transit. We conclude that normal aging prolongs the oral-pharyngeal swallow that impairs UES opening but does not influence pharyngo-sphincteric coordination.

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Endoscopic diagnosis and treatment of disorders of upper esophageal sphincter function

Techniques in Gastrointestinal Endoscopy ◽

10.1016/j.tgie.2018.07.005 ◽

2018 ◽

Vol 20 (3) ◽

pp. 139-145

Author(s):

Ronak V. Patel ◽

Ikuo Hirano

Keyword(s):

Upper Esophageal Sphincter ◽

Endoscopic Diagnosis ◽

Diagnosis And Treatment ◽

Sphincter Function ◽

Esophageal Sphincter

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Upper esophageal sphincter function in patients with Zenker's diverticulum

Dysphagia ◽

10.1007/bf02412426 ◽

1988 ◽

Vol 3 (2) ◽

pp. 90-92 ◽

Cited By ~ 18

Author(s):

T. Frieling ◽

W. Berges ◽

H. J. Lübke ◽

P. Enck ◽

M. Wienbeck

Keyword(s):

Upper Esophageal Sphincter ◽

Zenker’S Diverticulum ◽

Sphincter Function ◽

Zenker's Diverticulum ◽

Esophageal Sphincter

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Upper esophageal sphincter function during gastroesophageal reflux events revisited

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.2000.279.2.g262 ◽

2000 ◽

Vol 279 (2) ◽

pp. G262-G267 ◽

Cited By ~ 50

Author(s):

Silvia Torrico ◽

Mark Kern ◽

Muhammad Aslam ◽

Subashini Narayanan ◽

Ananda Kannappan ◽

...

Keyword(s):

Gastroesophageal Reflux ◽

Esophageal Pressure ◽

Upper Esophageal Sphincter ◽

Pressure Increase ◽

Sphincter Function ◽

Average Percentage ◽

Control Subjects ◽

Asymptomatic Volunteers ◽

Esophageal Sphincter ◽

Intraesophageal Pressure

Upper esophageal sphincter (UES) function during gastroesophageal reflux events is not completely elucidated because previous studies addressing this issue yielded conflicting results. We reexamined the UES pressure response to intraluminal esophageal pressure and pH changes induced by reflux events. We studied 14 healthy, asymptomatic volunteers (age 49 ± 6 yr) and 7 gastroesophageal reflux disease patients (age 48 ± 5 yr). UES pressure, intraesophageal pressure, and pH were monitored at the distal, middle, and proximal esophagus concurrently in the supine position 1 h before and 2 h after a 1,000-calorie meal. A total of 321 reflux events were identified by the development of abrupt reflux-induced intraesophageal pressure increase (IPI); 285 events occurred in patients and 36 in control subjects. In control subjects 33 of 36 and in patients 252 of 285 IPI events were associated with a pH drop. Among patients and control subjects, 99% and 100%, respectively, of all IPI events irrespective of pH drop were associated with abrupt increase in UES pressure (34 ± 2 and 27 ± 6 mmHg, respectively). The average percentage of maximum UES pressure increase over prereflux values ranged between 66% and 96% (control subjects) and 34% and 122% (patients). IPIs induced by both acidic and nonacidic reflux events evoke strong UES contractile responses.

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Upper esophageal sphincter impedance as a marker of sphincter opening diameter

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00473.2011 ◽

2012 ◽

Vol 302 (9) ◽

pp. G909-G913 ◽

Cited By ~ 29

Author(s):

Taher I. Omari ◽

Lara Ferris ◽

Eddy Dejaeger ◽

Jan Tack ◽

Dirk Vanbeckevoort ◽

...

Keyword(s):

Risk Index ◽

Upper Esophageal Sphincter ◽

Aim Analysis ◽

Luminal Diameter ◽

High Resolution Manometry ◽

Swallowing Dysfunction ◽

Pharyngeal Swallow ◽

Esophageal Sphincter ◽

Ues Opening ◽

Swallow Function

The measurement of the physical extent of opening of the upper esophageal sphincter (UES) during bolus swallowing has to date relied on videofluoroscopy. Theoretically luminal impedance measured during bolus flow should be influenced by luminal diameter. In this study, we measured the UES nadir impedance (lowest value of impedance) during bolus swallowing and assessed it as a potential correlate of UES diameter that can be determined nonradiologically. In 40 patients with dysphagia, bolus swallowing of liquids, semisolids, and solids was recorded with manometry, impedance, and videofluoroscopy. During swallows, the UES opening diameter (in the lateral fluoroscopic view) was measured and compared with automated impedance manometry (AIM)-derived swallow function variables and UES nadir impedance as well as high-resolution manometry-derived UES relaxation pressure variables. Of all measured variables, UES nadir impedance was the most strongly correlated with UES opening diameter. Narrower diameter correlated with higher impedance ( r = −0.478, P < 0.001). Patients with <10 mm, 10–14 mm (normal), and ≥15 mm UES diameter had average UES nadir impedances of 498 ± 39 Ohms, 369 ± 31 Ohms, and 293 ± 17 Ohms, respectively (ANOVA P = 0.005). A higher swallow risk index, indicative of poor pharyngeal swallow function, was associated with narrower UES diameter and higher UES nadir impedance during swallowing. In contrast, UES relaxation pressure variables were not significantly altered in relation to UES diameter. We concluded that the UES nadir impedance correlates with opening diameter of the UES during bolus flow. This variable, when combined with other pharyngeal AIM analysis variables, may allow characterization of the pathophysiology of swallowing dysfunction.

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Upper esophageal sphincter function during deglutition

Gastroenterology ◽

10.1016/0016-5085(88)90290-9 ◽

1988 ◽

Vol 95 (1) ◽

pp. 52-62 ◽

Cited By ~ 275

Author(s):

P.J. Kahrilas ◽

W.J. Dodds ◽

J. Dent ◽

J.A. Logemann ◽

R. Shaker

Keyword(s):

Upper Esophageal Sphincter ◽

Sphincter Function ◽

Esophageal Sphincter

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The Cricopharyngeus in the Neonate

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948008900515 ◽

1980 ◽

Vol 89 (5) ◽

pp. 446-449 ◽

Cited By ~ 2

Author(s):

Timothy J. Reichert ◽

Kenneth D. Faw

Keyword(s):

Upper Esophageal Sphincter ◽

Airway Protection ◽

Sphincter Function ◽

Cricopharyngeus Muscle ◽

Total Length ◽

Esophageal Sphincter ◽

Neonates And Infants

The cricopharyngeus muscle in neonates and infants has not been well established. It is found, like other laryngopharyngeal structures in infants, to be relatively much larger than its counterpart in the adult but not large enough to correlate with the total length of reported sphincter function. It also varies significantly in size, and therefore probably does not contribute completely to the function of the upper esophageal sphincter. Its relationship to airway protection, regurgitation and respiration needs to be more thoroughly studied.

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