Quantitation of pharyngeal motor function in normal human subjects

Abstract

A need exists for accurate pressure recording of pharyngeal motor events. Results of this study indicate that accurate quantitation of pharyngeal motor activity is not possible using a water-filled catheter system, even when high infusion rates are used. An intraluminal strain gauge system, however, achieves high-fidelity recording. Quantitation of pharyngeal peristalsis using the intraluminal strain gauge system reveals peristaltic pressure amplitudes higher than those hitherto recorded. In normal subjects, peristaltic amplitude averages about 200 mmHg in the hypopharynx, complexes in one subject being as high as 600 mmHg. A zone of relatively low pressure exists in the oropharynx. Mean pharyngeal wave duration decreases progressively in an aboral direction, from 1.0 to 0.3 s, and peristaltic wave speeds range between 9 and 25 cm/s. Accurate quantitation of pharyngeal peristaltic variables provides the necessary basis for characterization and assessment of pharyngeal motor disorders.

Evaluation of pharyngeal dysphagia with manofluorography

“…The oropharyngeal propulsive pressure is elevated to 60 mmHg (white arrow, L2). [14][15][16][17], electromyography [18], manometry with electromyography [19], and scintigraphy [20]. None of the aforementioned methods allows analysis of the pressure gradient in relationship to the bolus.…”

Manometric evaluation of the pharynx

“…Longitudinal, or axial, asymmetry of closing pressures within the human pharynx during swallowing was first shown by Dodds et al [2] in a study comparing infused manometry with solid state transducers. They demonstrated that the highest contraction pressures occur in the hypopharynx (1--4 cm above the UES high-pressure zone) with decreased pressures proximally in the oropharynx.…”

Investigative Techniques in the Assessment of Oral-Pharyngeal Dysphagia

“…Point sensors positioned within the UES 'drop out' of the sphincter, thereby registering an artefactual sphincter 'relaxation' [9,10]. The major disadvantage of perfusion manometry in the pharynx is its damped response rate which will underestimate the true peak amplitude of pharyngeal contractions [21]. However, there is a wide range of normal pressures in the pharynx, and a 'low'-amplitude contraction probably only has clinical significance if it falls below 60 mm Hg which is within the range accurately recorded by perfusion techniques.…”