2010
DOI: 10.1016/j.gie.2010.04.029
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Anatomic-manometric correlation of the upper esophageal sphincter: a concurrent US and manometry study

Abstract: Background The pharyngoesophageal segment commonly referred to as the upper esophageal sphincter (UES) generates a high-pressure zone (HPZ) between the pharynx and the esophagus. However, the exact anatomical components of the UES-HPZ remain incompletely determined. Objective To systematically define the US signature of various components of the pharyngoesophageal junction and to determine how these structures contribute to the development of the UES-HPZ. Design Prospective, experimental study. Setting T… Show more

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Cited by 17 publications
(15 citation statements)
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“…[23][24][25][26][27] Studies utilizing concurrent high-resolution ultrasonography, manometry, and fluoroscopy have defined the relative contribution of each of the three components to the UESHPZ. 28 These studies confirm prior assertions that the majority of the length of the UESHPZ in the center as well as its peak pressure is contributed by the CP, whereas the inferior constrictor and proximal esophagus donate to the two proximal and distal tails of the high-pressure zone, respectively. 24,26,27 The findings of the present study suggest that the orad extension in length and increase in pressure of the UESHPZ by application of pressure proximal to the cricoid cartilage is due to augmentation in the IPC area of the UESHPZ, whereas caudad extension in length and increase in pressure of the UESHPZ by application of pressure distal to the cricoid cartilage is due to augmentation in the proximal esophageal area of the UESHPZ.…”
Section: Discussionsupporting
confidence: 87%
See 1 more Smart Citation
“…[23][24][25][26][27] Studies utilizing concurrent high-resolution ultrasonography, manometry, and fluoroscopy have defined the relative contribution of each of the three components to the UESHPZ. 28 These studies confirm prior assertions that the majority of the length of the UESHPZ in the center as well as its peak pressure is contributed by the CP, whereas the inferior constrictor and proximal esophagus donate to the two proximal and distal tails of the high-pressure zone, respectively. 24,26,27 The findings of the present study suggest that the orad extension in length and increase in pressure of the UESHPZ by application of pressure proximal to the cricoid cartilage is due to augmentation in the IPC area of the UESHPZ, whereas caudad extension in length and increase in pressure of the UESHPZ by application of pressure distal to the cricoid cartilage is due to augmentation in the proximal esophageal area of the UESHPZ.…”
Section: Discussionsupporting
confidence: 87%
“…The UESHPZ is shaped by the pressures generated by its main component, namely the cricopharyngeus muscle (CP) and the pressures generated by contiguous muscles bordering the superior aspect of the CP, namely the inferior pharyngeal constrictor (IPC) and inferior aspect of the CP (i.e., the most proximal portion of the striated esophagus) . Studies utilizing concurrent high‐resolution ultrasonography, manometry, and fluoroscopy have defined the relative contribution of each of the three components to the UESHPZ . These studies confirm prior assertions that the majority of the length of the UESHPZ in the center as well as its peak pressure is contributed by the CP, whereas the inferior constrictor and proximal esophagus donate to the two proximal and distal tails of the high‐pressure zone, respectively …”
Section: Discussionsupporting
confidence: 75%
“…The high‐pressure zone of the UES has been shown by ultrasound to have a pharyngeal component, a CP component, and an upper esophageal component . The tone in this high‐pressure zone is due to tonic MN discharges in the MNs of the nucleus ambiguous, and cessation of this tonic discharge during swallowing results in cessation of EMG activity in the CP and thryopharyngeal muscles, while contraction of the suprahyoid muscles results in anterior lift of the hyoid, cricoid, and UES.…”
Section: Is There a Mechanical Relationship Between Anterior Hyoid Momentioning
confidence: 99%
“…Furthermore, upper esophageal sphincter contraction provides post‐swallowing pressures against the tail of the bolus being swallowed to facilitate clearance into the cervical esophagus. The cricopharyngeus muscle together with the inferior constrictor and cervical esophageal fibers comprise the upper esophageal sphincter …”
Section: Introductionmentioning
confidence: 99%
“…The cricopharyngeus muscle together with the inferior constrictor and cervical esophageal fibers comprise the upper esophageal sphincter. 9 In the context of disease, the cricopharyngeus may fail to open during swallowing due to neurogenic etiology or histologic changes to the muscle. [10][11][12] Radiographic studies of swallowing can be used to assess for cricopharyngeal dysfunction, with the radiographic sign described as a "cricopharyngeal bar."…”
Section: Introductionmentioning
confidence: 99%