Diagnosis of Swallowing Disorders: How We Interpret Pharyngeal Manometry
Open Access
- 13 March 2017
- journal article
- review article
- Published by Springer Science and Business Media LLC in Current Gastroenterology Reports
- Vol. 19 (3), 1-14
- https://doi.org/10.1007/s11894-017-0552-2
Abstract
Purpose of review We provide an overview of the clinical application of novel pharyngeal high-resolution impedance manometry (HRIM) with pressure flow analysis (PFA) in our hands with example cases. Recent findings In our Centre, we base our interpretation of HRIM recordings upon a qualitative assessment of pressure-impedance waveforms during individual swallows, as well as a quantitative assessment of averaged PFA swallow function variables. We provide a description of two global swallowing efficacy measures, the swallow risk index (SRI), reflecting global swallowing dysfunction (higher SRI = greater aspiration risk) and the post-swallow impedance ratio (PSIR) detecting significant post-swallow bolus residue. We describe a further eight swallow function variables specific to the hypopharynx and upper esophageal sphincter (UES), assessing hypo-pharyngeal distension pressure, contractility, bolus presence and flow timing, and UES basal tone, relaxation, opening and contractility. Summary Pharyngeal HRIM has now come of age, being applicable for routine clinical practice to assess the biomechanics of oropharyngeal swallowing dysfunction. In the future, it may guide treatment strategies and allow more objective longitudinal follow-up on clinical outcomes.Keywords
This publication has 30 references indexed in Scilit:
- The Relationship Between Residue and Aspiration on the Subsequent Swallow: An Application of the Normalized Residue Ratio ScaleDysphagia, 2013
- An impedance‐manometry based method for non‐radiological detection of pharyngeal postswallow residueNeurogastroenterology & Motility, 2012
- Upper esophageal sphincter impedance as a marker of sphincter opening diameterAmerican Journal of Physiology-Gastrointestinal and Liver Physiology, 2012
- Manofluorography in the Evaluation of Oropharyngeal DysphagiaDysphagia, 2012
- Reproducibility and Agreement of Pharyngeal Automated Impedance Manometry With VideofluoroscopyClinical Gastroenterology and Hepatology, 2011
- A Method to Objectively Assess Swallow Function in Adults With Suspected AspirationGastroenterology, 2011
- Optimal criteria for detecting bolus passage across the pharyngo-oesophageal segment during the normal swallow using intraluminal impedance recordingNeurogastroenterology & Motility, 2008
- Assessment of intraluminal impedance for the detection of pharyngeal bolus flow during swallowing in healthy adultsAmerican Journal of Physiology-Gastrointestinal and Liver Physiology, 2006
- A penetration-aspiration scaleDysphagia, 1996
- Fracture of the Occipital Condyle as an Incidental Finding during CT-Evaluation of a Maxillary FractureActa Radiologica, 1994