Recent Developments in the Manometric Assessment of Upper Esophageal Sphincter Function and Dysfunction

Castell, June A.; Castell, Donald O.

doi:10.1159/000171619

Cited by 13 publications

(10 citation statements)

References 23 publications

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“…Whether the protective properties of the upper esophageal sphincter were overcome because of reflux‐induced transient relaxations or a defect function, such as a disturbed pharyngeal‐upper esophageal sphincter contractile reflex or an altered basal upper esophageal sphincter pressure, was not evaluated in the present study because the conventional water‐perfused system that was used was not optimal for that task. 11 …”

Section: Discussionmentioning

confidence: 99%

Hypopharyngeal Acid Exposure: An Independent Risk Factor for Laryngeal Cancer?

2003

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Section: Discussionmentioning

confidence: 99%

Hypopharyngeal Acid Exposure: An Independent Risk Factor for Laryngeal Cancer?

2003

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“…Once the high-pressure zone of the UES was identified, the catheter was stabilized in the high-pressure zone for approximately 20 s and UES resting pressure was recorded. The catheter was then pulled back (i.e., moved superiorly) an additional 1–2 cm so that UES relaxation could be measured at the height of the swallow (i.e., to compensate for laryngeal elevation with swallowing), and the characteristic M-wave [21] was seen in the channel for sensor one. A posterior orientation of sensors two and three at the levels of the inferior constrictor and the base of the tongue, respectively, was obtained and assured via endoscopic visualization throughout data collection.…”

Section: Methodsmentioning

confidence: 99%

The Effects of Aspiration Status, Liquid Type, and Bolus Volume on Pharyngeal Peak Pressure in Healthy Older Adults

et al. 2010

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The reasons for aspiration in healthy adults remain unknown. Given that the pharyngeal phase of swallowing is a key component of the safe swallow, it was hypothesized that healthy older adults who aspirate are likely to generate less pharyngeal peak pressures when swallowing. Accordingly, pharyngeal and upper esophageal sphincter pressures were examined as a function of aspiration status (i.e., nonaspirator vs. aspirator), sensor location (upper vs. lower pharynx), liquid type (i.e., water vs. milk), and volume (i.e., 5 vs. 10 ml) in healthy older adults. Manometric measurements were acquired with a 2.1-mm catheter during flexible endoscopic evaluation. Participants (N = 19, mean age = 79.2 years) contributed 28 swallows; during 8 swallows, simultaneous manometric measurements of upper and lower pharyngeal and upper esophageal pressures were obtained. Pharyngeal manometric peak pressure was significantly less for aspirators (mean = 82, SD = 31 mmHg) than for nonaspirators (mean = 112, SD = 20 mmHg), and upper pharyngeal pressures (mean = 85, SD = 32 mmHg) generated less pressure than lower pharyngeal pressures (mean = 116, SD = 38 mmHg). Manometric measurements vary with respect to aspiration status and sensor location. Lower pharyngeal pressures in healthy older adults may predispose them to aspiration.

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“…Study findings indicate that the characteristic spatial pressure distribution shown by earlier studies 1–6 was significantly altered by using a manometric catheter with a smaller diameter and configuration conforming to the UES anatomy in both young and elderly. In that, similar to prior studies 1–6 the round catheter assembly measured pressures that were significantly greater anteriorly and posteriorly compared with pressures recorded from lateral directions. This radial asymmetry was not present in the UES pressure profile when the smaller diameter conforming catheter assembly was used for measurement.…”

Section: Discussionmentioning

confidence: 71%

“…Radial asymmetry of the upper oesophageal sphincter high‐pressure zone (UESHPZ) is an accepted notion based on manometric studies profiling the resting pressure phenomenon within the UES 1–7 …”

Section: Introductionmentioning

confidence: 99%

Radial asymmetry of the upper oesophageal sphincter pressure profile: fact or artefact

Bardan

Kern

Torrico

et al. 2006

Neurogastroenterology Motil

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Radial asymmetry of the upper oesophageal sphincter high-pressure zone (UESHPZ) is an accepted notion based on manometric studies. Our aim was to evaluate the effect of the catheter diameter and configuration on the resting pressure profile of the UES. We studied 14 young (30 +/- 2 years) and 14 healthy elderly volunteers (77 +/- 2 years) using the station pull-through technique. We used a specially designed water perfused manometric assembly that incorporated a proximal round cross-section (4.8 mm) and a distal flat cross-section (4.8 x 1.2 mm). Anterior and posterior manometric sites on the round catheter measured significantly higher pressure values than did the sites oriented laterally at the same level (P < 0.001) in both young and elderly. In contrast, the flat-shaped catheter measured statistically indistinguishable pressures from all four orientations in both age groups. In both young and elderly the anterio-posterior, but not lateral pressures by the round catheter were significantly higher (P < 0.001) than those of the flat catheter. An exaggerated anteriorly and posteriorly oriented pressure may be recorded compared with lateral pressures depending on the diameter and non-conforming shape of the recording catheter with respect to the UES producing the appearance of radial asymmetry in the UESHPZ.

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Recent Developments in the Manometric Assessment of Upper Esophageal Sphincter Function and Dysfunction

Cited by 13 publications

References 23 publications

Hypopharyngeal Acid Exposure: An Independent Risk Factor for Laryngeal Cancer?

Hypopharyngeal Acid Exposure: An Independent Risk Factor for Laryngeal Cancer?

The Effects of Aspiration Status, Liquid Type, and Bolus Volume on Pharyngeal Peak Pressure in Healthy Older Adults

Radial asymmetry of the upper oesophageal sphincter pressure profile: fact or artefact

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