A systematic review of current methodology of high resolution pharyngeal manometry with and without impedance

Winiker, Katharina; Gillman, Anna; Hernandez, Esther Guiu; Huckabee, Maggie‐Lee; Gozdzikowska, Kristin

doi:10.1007/s00405-018-5240-9

Cited by 18 publications

(9 citation statements)

References 76 publications

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“…The nadir UES pressure, i.e., the lowest UES pressure during relaxation, was also measured. Velopharyngeal, mesopharyngeal, hypopharyngeal, and whole pharyngeal contractile integrals and the UES integrated relaxation pressure were analyzed using a semiautomated analysis portal (Swallow Gateway™) [25][26][27]. These pharyngoesophageal integral metrics are in line with the International High-Resolution Pharyngeal Manometry Working Group recommendations [11]; the metrics used in this study are defined in Table 1.…”

Section: Data Collection and Analysismentioning

confidence: 99%

Effect of Tongue-Hold Swallow on Pharyngeal Contractile Properties in Healthy Individuals

et al. 2021

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Tongue-hold swallow (THS) is a swallow exercise in which an individual swallows saliva while holding the anterior portion of the tongue between the front teeth. The effect of THS on pharyngeal contractile vigor is still unclear. The purpose of this study was to quantify THS using high-resolution manometry with a contractile integral analysis. Twenty-two healthy participants performed three different saliva swallow tasks: normal swallow, weak THS (in which the tongue was protruded 1 cm outside the upper incisors), and strong THS (in which the tongue was protruded 2 cm outside the upper incisors). The participants repeated each task twice randomly. Pharyngeal and upper esophageal sphincter metrics, including the pharyngeal contractile integral, were analyzed. Both weak and strong THS enhanced the velopharyngeal contractile integral and peak pressure compared with normal swallow (P < 0.01). THS also prolonged mesopharyngeal contraction (P < 0.01). Holding the tongue anteriorly during swallow requires significant biomechanical changes to pharyngeal contractile properties at the superior and middle pharyngeal constrictor levels; thus, it may serve as a resistance exercise for the muscles that are involved in bolus propulsion.

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Section: Data Collection and Analysismentioning

confidence: 99%

Effect of Tongue-Hold Swallow on Pharyngeal Contractile Properties in Healthy Individuals

et al. 2021

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“…One study [ 23 ] utilised the ManoView software. This software requires correction of a system-based measurement fault [ 31 ]. The study did not state whether the correction was made.…”

Section: Resultsmentioning

confidence: 99%

“…Each of these variables can alter the pressure measurements obtained, limiting comparison of study findings [ 18 ]. Winiker et al [ 31 ] reported considerable variability in PHRM protocol and gaps in documentation of such protocol across the literature. This review reveals that studies using PHRM in PwMND are no exception to these gaps or discrepancies.…”

Section: Discussionmentioning

confidence: 99%

Use of Pharyngeal High-Resolution Manometry to Evaluate Dysphagia in Adults with Motor Neurone Disease: A Scoping Review

Diver

Regan

2022

Dysphagia

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There has been a recent shift towards proactive dysphagia intervention in motor neurone disease (MND) to maintain physiological reserve. Pharyngeal high-resolution manometry (PHRM) can quantify swallowing pathophysiology to inform and evaluate proactive dysphagia intervention. This study aims to explore the current use of PHRM as a dysphagia evaluation in adults with MND. A scoping review based on the Joanna Briggs Framework was completed. Four electronic databases (PubMed, EMBASE, CINAHL and Web of Science core) were searched (inception to March 2021) by two independent researchers. Data were analysed according to (i) PHRM protocol and analysis methods and the feasibility of same, (ii) swallow biomechanics data and (iii) dysphagia intervention effects as measured by PHRM. Six studies with 78 people with MND (PwMND) were included. There was considerable variation in PHRM protocol and analysis methods. Five studies reported a 100% completion rate and three studies reported no adverse events. Swallow biomechanics data were reported across all studies. The effects of sensory stimulation, increased bolus consistency, effortful swallow and cricopharyngeal myotomy were evaluated using PHRM with 20 PwMND across four studies with varying effects. Literature on the use of PHRM in PwMND is limited. Variability in PHRM methods restricts comparison of metrics. PHRM appears to be a feasible tool for PwMND. PHRM can provide novel swallow physiology data in PwMND and quantify discrete effects of compensatory and surgical dysphagia interventions not detectable by videofluoroscopy or FEES. Further research on the effects of proactive dysphagia intervention as measured by PHRM is required.

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“…Data from sixty swallows was exported to a semi-automated online analysis software (www.swallowgateway.com Flinders University, Adelaide, Australia). This software has been previously used to analyse HRM data (Regan, 2020;Winiker et al, 2019).…”

Section: Data Collection and Analysismentioning

confidence: 99%

Effect of effortful swallow on pharyngeal pressures during swallowing in adults with dysphagia: A pharyngeal high-resolution manometry study

Heslin

Regan

2021

International Journal of Speech-Language Pathology

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Purpose: Evidence base to support use of the effortful swallow in clinical populations with dysphagia is currently lacking. This study aims to quantify the effects of effortful swallowing on pharyngeal swallowing biomechanics in adults with dysphagia using pharyngeal high-resolution manometry (PHRM).Method: ManoScan HRM equipment with a 4.2 mm pressure catheter was used.Participants completed duplicate 10ml baseline and 10ml effortful liquid (IDDSI Level 0) swallows in randomized order. PHRM data were analysed using a semiautomated online platform (www.swallowgateway.com).Result: Fifteen adults (8 males; range 45-86 years) with mixed aetiology dysphagia (Functional Oral Intake Scale Level 2-5) were included. Median pharyngeal contractile (156.81 mmHg cm s; IQR 80.62) increased significantly (213.50 mmHg cm s; IQR 117.2) during effortful swallowing (p = 0.002). Significant increases were also observed in velopharyngeal pressure (p = 0.001), mesopharyngeal pressure (p = 0.027), hypopharyngeal pressure (p = 0.003) and UOS relaxation duration (p = 0.002). UOS IRP was not significantly altered with effortful swallowing (p = 0.233). Conclusion:Effortful swallowing induced significant biomechanical changes to swallowing in adults with dysphagia. Increases in global pharyngeal rigor, tongue base pressure and UOS opening duration were captured by PHRM during effortful swallowing. Further investigation in larger homogeneous clinical populations is needed to verify the physiological effects of this frequently employed intervention.

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A systematic review of current methodology of high resolution pharyngeal manometry with and without impedance

Cited by 18 publications

References 76 publications

Effect of Tongue-Hold Swallow on Pharyngeal Contractile Properties in Healthy Individuals

Effect of Tongue-Hold Swallow on Pharyngeal Contractile Properties in Healthy Individuals

Use of Pharyngeal High-Resolution Manometry to Evaluate Dysphagia in Adults with Motor Neurone Disease: A Scoping Review

Effect of effortful swallow on pharyngeal pressures during swallowing in adults with dysphagia: A pharyngeal high-resolution manometry study

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