The Effects of Bolus Volume and Texture on Pharyngeal Pressure Events Using High-resolution Manometry and Its Comparison with Videofluoroscopic Swallowing Study

Ryu, Ju Seok; Park, Donghwi; Oh, Yoongul; Lee, Seok Tae; Kang, Jin Young

doi:10.5056/jnm15095

Cited by 32 publications

(38 citation statements)

References 22 publications

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“…The faster pharyngeal bolus transit might be associated with the increase in upstream intrabolus pressure with the increase in the bolus volume 20 - 22 , or a likely increase in the base of the tongue pressure. However, a previous investigation did not find alterations in the maximal tongue base pressure with the variation of bolus volumes 23 . The explanation for the alteration of the bolus transit duration might be the UES alteration with the increase in the bolus volume, with a decrease in the minimal UES pressure with the increase in the bolus volume 23 , which could facilitate bolus propulsion and transit through the pharynx.…”

Section: Discussionmentioning

confidence: 74%

“…However, a previous investigation did not find alterations in the maximal tongue base pressure with the variation of bolus volumes 23 . The explanation for the alteration of the bolus transit duration might be the UES alteration with the increase in the bolus volume, with a decrease in the minimal UES pressure with the increase in the bolus volume 23 , which could facilitate bolus propulsion and transit through the pharynx.…”

Section: Discussionmentioning

confidence: 74%

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Videofluoroscopic analysis of different volumes of liquid bolus swallowing in healthy individuals: comparison between height and sex

Regueiro¹,

Nascimento²,

Parreira³

et al. 2017

Clinics

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OBJECTIVE:The volume of swallowed bolus affects the pharyngeal transit duration. The sex and corporal height of individuals may likely influence this effect. The aim of this investigation was to determine the influence of sex and corporal height on the pharyngeal transit modification produced by the swallowed bolus volume.METHODS:Forty healthy volunteers, 20 men and 20 women, including tall (10 men and 10 women, corporal height: 1.71--2.07m) and short (10 men and 10 women, corporal height: 1.52--1.70m) persons, ranging in age between 20 and 50 years, were included in the study. Videofluoroscopic evaluation of swallowing was performed with the subjects in the sitting position. Each individual swallowed three 5 mL and three 10 mL boluses of liquid barium in a random sequence. The durations of oral transit, pharyngeal transit, pharyngeal clearance, hyoid movement, upper esophageal sphincter opening and oral-pharyngeal transit were evaluated.RESULTS:In men and women, and in taller and shorter individuals, the increase of the swallowed liquid bolus volume from 5 mL to 10 mL causes a faster transit of the bolus tail from the oral-pharyngeal transition to the upper esophageal sphincter and an increase in the duration of the upper esophageal sphincter opening, with similar alteration in men and women and in taller and shorter individuals.CONCLUSION:An increase in the swallowed liquid bolus volume from 5 mL to 10 mL causes a faster pharyngeal bolus transit and a longer bolus transit through the upper esophageal sphincter, with similar alterations in men and women and in shorter and taller individuals.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 74%

Videofluoroscopic analysis of different volumes of liquid bolus swallowing in healthy individuals: comparison between height and sex

Regueiro¹,

Nascimento²,

Parreira³

et al. 2017

Clinics

View full text Add to dashboard Cite

show abstract

“…Das Druckmaximum im oÖS nach der Relaxation zeigte ebenfalls keine volumenabhängigen Unterschiede [14]. Ryu et al geben zwar ebenfalls eine Zunahme der velopharyngealen Kontraktionsdauer an, volumenabhängige Veränderungen im Hypopharynx wurden aber nicht beobachtet [15]. Die Zunahme des Residualdrucks im oÖS sowie eine Verlängerung der Relaxationszeit mit steigendem Schluckvolumen wurde von Lin et al bestätigt [2].…”

Section: Introductionunclassified

Einfluss des Schluckvolumens auf die Pharynxdynamik, evaluiert mit dünnen Hochauflösungsmanometriesonden

2017

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The bolus volume has a modulating effect on the swallowing dynamics, but previously reported adaptations of the pharyngeal function have been inconsistent. Therefore, the aim of this study was to comprehensively evaluate changes of pressure and time parameters in the pharynx and upper esophageal sphincter (UES) in relation to the swallowed bolus volume with high-resolution manometry (HRM). To examine the normal swallowing physiology, particularly thin HRM probes were used, which were expected to influence the investigated structures only minimally.10 healthy volunteers accomplished 10 swallows with 2 and 10 ml water respectively in an upright position, while an HRM-examination was performed. Pressure and time parameters of the velopharynx, the tongue base region and the UES were determined and analyzed for statistical differences with respect to the bolus volume.Swallowing larger bolus volumes resulted in both, a longer closure of the velopharynx and in a longer opening of the UES. Volume dependent pressure changes in the pharyngeal swallowing sequence were not detectable.Under the chosen test conditions, bolus volume had an impact on the time parameters of the pharyngeal phase, thus, temporal adaptations of the automated swallowing dynamics were detected. Changes in pharyngeal pressure parameters as shown in other studies cannot be confirmed. They may be due to HRM probes with a larger diameter, which take an effect on the pharyngeal structures themselves. With regard to diagnostic aspects, HRM studies should always be conducted with different bolus volumes in order to investigate the swallowing process completely.

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“…Differences in bolus sizes and textures have additionally been evaluated [83,84]. Pharyngeal HRM has also been used to evaluate pharyngeal dysphagia in patients - for example, those following stroke [85], with Parkinson's disease [86] and with myotonic dystrophy [87].…”

Section: Pharyngeal Manometrymentioning

confidence: 99%

“…Research applications of HRM rely heavily on software such as MATLAB to analyse pharyngeal swallowing with custom algorithms outside of commercial HRM devices [78,79,80,81,82,83,91], and reliability of pharyngeal HRM is limited to one study investigating a custom MATLAB programme. The reliability of a custom-designed software programme was evaluated after provision of a 20-min training session to 20 raters with varying experience (e.g., expert and novice speech-language pathologists) [91].…”

Section: Pharyngeal Manometrymentioning

confidence: 99%

Expanding Instrumental Options for Dysphagia Diagnosis and Research: Ultrasound and Manometry

Huckabee

Macrae²,

Lamvik³

2015

Folia Phoniatr Logop

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Diagnostic assessment of swallowing in routine clinical practice relies heavily on the long-standing techniques of videofluoroscopic swallowing study (VFSS) and videoendoscopic evaluation of swallowing (VEES). These complementary and sophisticated techniques provide a real-time visualization of biomechanical movements of the structures involved in swallowing and consequent effects on bolus flow. Despite the sophistication of this instrumentation, interpretation relies heavily on subjective clinical judgement and temporal resolution is limited, limitations that may influence patient management. Adjunctive diagnostic assessments may be utilized to compensate for the limitations posed by VFSS and VEES. Ultrasound and pharyngeal manometry do not represent the latest in technological advances, with both emerging in swallowing research over 20 years ago. However, both have resisted integration into routine clinical practice, despite the fact that they offer quantitative metrics of swallowing that are not available using standard techniques. The aim of this review is to present recent research on these two less frequently used modalities in clinical swallowing assessment, discuss potential applications in clinical practice and review supportive data on test-retest reliability, rater reliability and validity. The paper will conclude with a case report that exemplifies the unique contribution of these modalities in executing and revising therapeutic approaches for a patient with neurogenic dysphagia.

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The Effects of Bolus Volume and Texture on Pharyngeal Pressure Events Using High-resolution Manometry and Its Comparison with Videofluoroscopic Swallowing Study

Cited by 32 publications

References 22 publications

Videofluoroscopic analysis of different volumes of liquid bolus swallowing in healthy individuals: comparison between height and sex

Videofluoroscopic analysis of different volumes of liquid bolus swallowing in healthy individuals: comparison between height and sex

Einfluss des Schluckvolumens auf die Pharynxdynamik, evaluiert mit dünnen Hochauflösungsmanometriesonden

Expanding Instrumental Options for Dysphagia Diagnosis and Research: Ultrasound and Manometry

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