The effect of manometric assembly diameter on intraluminal esophageal pressure recording

Lydon, Sean B.; Dodds, Wylie J.; Hogan, Walter J.; Arndorfer, Ronald C.

doi:10.1007/bf01070885

Cited by 61 publications

(30 citation statements)

References 9 publications

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“…Catheter diameter is another important variable in the consideration of reported values for pressure measurements. Earlier studies have shown that catheters of different diameters will measure different pressures [13,14]. These findings have been confirmed by Wilson et al [4] although the catheters they used were not only of differing diameters but also of different types.…”

Section: Asymmetrysupporting

confidence: 63%

Modern solid state computerized manometry of the pharyngoesophageal segment

Castell

1993

Dysphagia

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There has been renewed interest in the use of manometry of the pharyngoesophageal segment in the investigation of pharyngeal dysphagia. Advances in technology have alleviated previous difficulties presented by factors such as the rapid response rate of the striated muscle and asymmetry of the upper esophageal sphincter. Close attention to technique can overcome difficulties with movement artifacts encountered during deglutition. Manometry is being used to study normal swallow function and the effects of physiologic changes. There are also increasing numbers of reports in the literature of manometric studies in patients with oropharyngeal dysphagia. This technique provides information on pressure changes and augments that information obtained from a barium swallow.

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Section: Asymmetrysupporting

confidence: 63%

Modern solid state computerized manometry of the pharyngoesophageal segment

Castell

1993

Dysphagia

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“…The effective diameter, Do~, is related to D (the diameter of a tube without a pharynx, for example, a question might be raised about the effect of a tube on the effectiveness of a stripping wave in clearing the pharyngeal lumen. In the esophagus, the contractile characteristics are reported to be affected by distention of the esophageal lumen by the manometric probe previous to neurologic stimulation of muscle contraction [12,13]. Specifically, the larger the catheter diameter, the higher the pressure amplitude from within the closed segment.…”

Section: What Does a Manometermentioning

confidence: 99%

Interpretation of intraluminal manometric measurements in terms of swallowing mechanics

1991

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A unified discussion of the mechanics of the swallowing process, and its interpretation through manometric measurements of intraluminal pressure, are presented in this paper. The goals of the discussions are to provide the reader with basic knowledge of pharyngeal, esophageal, and sphincter mechanics; to relate the mechanical processes to intraluminal pressure recordings; and to clarify the relationship between intraluminal pressure and esophageal muscle contractile behavior. The esophageal phase of bolus transport, in particular, is discussed in some detail due to the relatively simple geometry and the straightforward description of peristalsis and muscle mechanics in this region. Several important issues are emphasized in the discussion. For example, pressure variation within a static bolus is fundamentally different from that within a moving bolus. Manometric recordings must be interpreted accordingly. The importance of differentiating between "hydrodynamic pressure," which is pressure measured within a fluid bolus, and "contact pressure," which is the direct squeeze of the luminal wall on the manometric port in a region devoid of bolus fluid, is discussed in some detail. We argue that pressure "amplitude" does not, in principle, give any indication of the forces required to drive the fluid bolus forward. What should be sought is the variation of intrabolus pressure relative to the contact pressure, particularly during periods in which the contractile segment fails to obliterate the esophageal lumen. Examples of intraluminal pressure recording in the esophagus, using manometry and mathematical models, are presented to demonstrate both the possibilities and the difficulties of interpreting manometric recordings in the absence of concurrent radiographic imaging. We discover that in regions of nearly complete luminal closure, the pressure signature and bolus geometry are strongly coupled during peristaltic transport, providing the possibility that in these regions quantitative measures of muscle performance might be developed without the need for radiographic imaging. On the other hand, the ambiguity in the interpretation of manometric recordings that often accompanies dysphagic conditions suggests that as more sophisticated interpretations are sought, manometry concurrent with radiography will play a more prominent role in patient evaluation.

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“…Although circumferential sensors alleviate the issue of radial pressure asymmetry, the increased diameter required to accommodate the sensors may counteract this advantage when looking at pressures in the pharynx. Variation in manometric recordings has been confirmed in relation to an increase in catheter diameter [23], as well as in response to stress [24], which could arguably play a role in the tolerance of a larger catheter. In addition, bolus flow is influenced by catheter diameter [17], suggesting that a smaller-diameter catheter may provide more representative pharyngeal pressures related to swallowing.…”

Section: Discussionmentioning

confidence: 93%

Pharyngeal Pressures During Swallowing Within and Across Three Sessions: Within-Subject Variance and Order Effects

Macrae

Myall²,

Jones

et al. 2011

Dysphagia

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No studies have investigated within-subject variation in measures of pharyngeal pressures during swallowing across sessions. This study aimed to document the variation in pharyngeal pressures both within and across three sessions. Twenty healthy participants were recruited for three sessions. For each session, peak or nadir pressures were recorded from the upper pharynx (sensor 1), mid-pharynx (sensor 2), and upper esophageal sphincter (sensor 3) during saliva and 10-ml water bolus swallows. Variance was larger across sessions than within sessions for sensors 1 and 2 but comparable for sensor 3. For all sensors there was a high correlation between the variance across sessions and within session (r = 0.92, p < 0.0001). There were no significant order effects of session or of trial at any sensor with estimated order effects less than 2% and the estimated maximum possible change no larger than 5% for trial and no larger than 12% for session. These data offer direction for longitudinal treatment studies in which pharyngeal pressures are an outcome measurement by (1) providing a basis for power calculations, (2) estimating the likely values of any confounding order effects, and (3) providing suggestions for more reliable data analysis.

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The effect of manometric assembly diameter on intraluminal esophageal pressure recording

Cited by 61 publications

References 9 publications

Modern solid state computerized manometry of the pharyngoesophageal segment

Modern solid state computerized manometry of the pharyngoesophageal segment

Interpretation of intraluminal manometric measurements in terms of swallowing mechanics

Pharyngeal Pressures During Swallowing Within and Across Three Sessions: Within-Subject Variance and Order Effects

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