Investigation of Pharyngeal Swallowing Function Using High‐Resolution Manometry

Takasaki, Kenji; Umeki, Hiroshi; Enatsu, Kaori; Tanaka, Fujinobu; Sakihama, Naoko; Kumagami, Hidetaka; Takahashi, Haruo

doi:10.1097/mlg.0b013e31817dfd02

Cited by 94 publications

(128 citation statements)

References 13 publications

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“…First, researchers have reported that average resting UES pressure was 50-70 mmHg. 12,16,25 Median resting UES pressure in our study was also very similar to that value; 78.8 mmHg (range, 68.8-102.3). Second, if the reference value is set too low, it would be very difficult to distinguish muscular contraction by UES and upper esophageal sphincter.…”

Section: Discussionsupporting

confidence: 64%

“…Until recently, researchers have investigated pharyngeal contractility by estimating the peak pharyngeal pressure at 2 anatomical locations; upper and lower pharynx, or velo, meso-, or hypopharynx. 5,12,23 However, peak pharyngeal pressure only shows the highest pressure for a short time and it is difficult to say that it represents the contractility of the whole pharynx. CI was recently developed as a way of quantifying the overall vigor of contraction, and it is known to be sensitive in delineating abnormalities involving sustained or hypertensive esophageal contractions.…”

Section: Discussionmentioning

confidence: 99%

“…9 Several studies already have reported detailed analyses of UES and pharyngeal muscles with a HRM and suggested normative values for manometric data. 5,[10][11][12] However, there are several points to consider in previous manometric analyses of UES and pharyngeal function. First, little data is available concerning the correlation between manometric and VFSE findings.…”

Section: Introductionmentioning

confidence: 99%

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Videofluoroscopic and Manometric Evaluation of Pharyngeal and Upper Esophageal Sphincter Function During Swallowing

Yoon

Park

et al. 2014

J Neurogastroenterol Motil

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Background/AimsThe purpose of this study was to determine important manometric metrics for the analysis of pharyngeal and upper esophageal sphincter (UES) function and to investigate the effect of viscosity and other confounding factors on manometric results. MethodsManometric studies were performed on 26 asymptomatic volunteers (12 men and 14 women; age, 19-81 years). The manometric protocol included 5 water swallows (5 mL), 5 barium swallows (5 mL) and 5 yogurt swallows (5 mL). Evaluation of high-resolution manometry parameters including basal pressure of the UES, mesopharyngeal contractile integral (mesopharyngeal CI, mmHg ‧ cm ‧ sec), CI of the hypopharynx and UES (hypopharyngeal CI), relaxation interval of UES, median intrabolus pressure and nadir pressure at UES was performed using MATLAB. ResultsMesopharyngeal CIs for barium and yogurt swallows were significantly lower than those for water swallows (both P < 0.05). Hypopharyngeal CIs for water swallows were significantly lower than those for barium swallows (P = 0.004), and median bolus pressure at UES for barium swallows was significantly higher than that for water and yogurt swallows (both P < 0.05). Furthermore, hypopharyngeal CI and median intrabolus pressure at UES were significantly related to age for 3 swallows (all P < 0.01 and P < 0.05, respectively). A significant negative correlation was also noted between nadir pressure at UES and age for water and yogurt swallows (all P < 0.05). ConclusionsManometric measurement of the pharynx and UES varies with respect to viscosity. Moreover, age could be a confounding variable in the interpretation of pharyngeal manometry.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Videofluoroscopic and Manometric Evaluation of Pharyngeal and Upper Esophageal Sphincter Function During Swallowing

Yoon

Park

et al. 2014

J Neurogastroenterol Motil

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“…Therefore, pressure measurement equipment must have a very short response time [8]. Hence, the pathophysiology of formation of ZD is not clear.…”

Section: Aetiologymentioning

confidence: 99%

Pulsion Diverticulum of the Oesophagus: More than just an Out Pouch

Sonbare

2013

Indian J Surg

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Oesophageal diverticulum is divided into two types based on the aetiology: the pulsion and the traction diverticula. Pulsion diverticulum occurs due to increased intraluminal pressure. This can be of three types based on the location along the oesophagus: the Zenker's diverticulum (ZD), the midoesophageal diverticulum (MD) and the epiphrenic diverticulum (ED). A PubMed search was conducted for the words 'pulsion', 'diverticulum' and 'oesophagus' for all studies published from January 1980 to March 2013 in the English language. A total of 31 studies were identified, and out of which, five were not included in the review. The pulsion diverticulum of the oesophagus is an uncommon disorder. Its aetiology is related to the motility disorders of the oesophagus. Patients usually present with chest-related symptoms or oesophageal symptoms, which are related to the underlying motility disorder. Evaluation includes barium studies, gastrointestinal endoscopy, CT scan and oesophageal manometry. Surgery is the treatment of choice for symptomatic and large diverticula, although the outcome in asymptomatic patients is unknown. The surgical options include diverticulectomy or diverticulopexy with an adequate myotomy. Most patients with ZD are now treated by using endoscopic techniques, although no randomised trial has shown its superiority over the open technique. Minimally invasive surgery has also been used for patients with MD and ED. Although isolated case series has shown good improvement in symptoms and reduction in mortality with minimally invasive techniques in patients with ED, its role in thoracic oesophageal diverticulum is debated.

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“…Although several studies have demonstrated that HRM is useful in identifying the motor behavior of the different elements involved in the pharyngo-esophageal phase of swallowing (97) and the prospect of automatically analyzing this area seems ever closer (98), the current situation shows that:…”

Section: Current Situationmentioning

confidence: 99%

Practical aspects of high resolution esophageal manometry

Juan¹,

Ríos²,

Bueno³

et al. 2016

Rev Esp Enferm Dig

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High resolution esophageal manometry (HRM) is currently under development as can be seen in the various Chicago classifications. In order to standardize criteria in certain practical aspects with limited scientific evidence, the First National Meeting for Consensus in High Resolution Manometry of the Spanish Digestive Motility Group took place, bringing together a wide group of experts. The proposals were based on a prior survey composed of 47 questions, an exhaustive review of the available literature and the experience of the participants. Methodological aspects relating to the poorly defined analysis criteria of certain new high resolution parameters were discussed, as well as other issues previously overlooked such as spontaneous activity or secondary waves. Final conclusions were drawn with practical applications.

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Investigation of Pharyngeal Swallowing Function Using High‐Resolution Manometry

Cited by 94 publications

References 13 publications

Videofluoroscopic and Manometric Evaluation of Pharyngeal and Upper Esophageal Sphincter Function During Swallowing

Videofluoroscopic and Manometric Evaluation of Pharyngeal and Upper Esophageal Sphincter Function During Swallowing

Pulsion Diverticulum of the Oesophagus: More than just an Out Pouch

Practical aspects of high resolution esophageal manometry

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