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European Archives of Oto-Rhino-Laryngology

, Volume 275, Issue 9, pp 2303–2310 | Cite as

Comparison of unidirectional and circumferential manometric measures within the pharyngoesophageal segment: an exploratory study

  • Esther Guiu HernandezEmail author
  • Kristin Gozdzikowska
  • Richard Jones
  • Maggie-Lee Huckabee
Laryngology
  • 66 Downloads

Abstract

Background

Notable differences have been identified between low-resolution manometry (LRM) and high-resolution manometry (HRM) in normative data.

Objective

This study aimed to investigate within-subject differences between unidirectional LRM and circumferential HRM solid-state measurement sensors in the pharyngoesophageal segment during swallowing.

Methods

Ten healthy subjects (mean 26.9 years) were evaluated with both a 2.10 mm unidirectional catheter and a 2.75 mm circumferential catheter, with randomized order of catheter placement. Unidirectional measurements were made in four directions (posterior, anterior, right-lateral, left-lateral). Pressures and durations were analyzed to compare (1) posterior to anterior and lateral recordings and (2) posterior and average-LRM measures (C-LRM) to HRM measures at same anatomical location.

Results

No significant differences were found in any of the measures across the four radial directions. A lower amplitude was measured in C-LRM compared to HRM for pharyngeal sensors (LRM Sensor 1: − 39.7 mmHg; Sensor 2: − 61.4 mmHg). Compared with posterior-LRM, HRM recorded higher UES pressures (− 12.8 mmHg) and longer UES relaxation durations (− 0.31 s).

Conclusion

This exploratory study is the first to compare within-subject pressures between unidirectional LRM and circumferential HRM. Substantial differences in pharyngeal manometric measures were found, particularly with regard to UES function. This is clinically important as manometry is uniquely able to evaluate UES function and clarify differential diagnoses in patients with dysphagia.

Keywords

Pharyngeal manometry High-resolution manometry Deglutition Pharynx 

Notes

Acknowledgements

The authors thank Kerstin Erfmann and Katharina Winiker for their collaboration in data collection and inter-rater reliability. The authors acknowledge the Canterbury Medical Research Foundation for its support of this research. EGH provided technical expertise in MATLAB software program and KG conducted the studies. All authors contributed to the research study design, analysis, and manuscript preparation.

Compliance with ethical standards

Conflict of interest

The authors declare they have no conflicts of interest.

References

  1. 1.
    Salassa JR, DeVault KR, McConnel FM (1998) Proposed catheter standards for pharyngeal manofluorography (videomanometry). Dysphagia 13(2):105–110CrossRefPubMedGoogle Scholar
  2. 2.
    Olsson R, Castell JA, Castell DO, Ekberg O (1995) Solid-state computerized manometry improves diagnostic yield in pharyngeal dysphagia: simultaneous videoradiography and manometry in dysphagia patients with normal barium swallows. Abdom Imaging 20(3):230–235CrossRefPubMedGoogle Scholar
  3. 3.
    Pauloski R, Rademaker A, Lazarus C, Boeckxstaens G (2009) Relationship between manometric and videofluoroscopic measures of swallow function in healthy adults and patients treated for head and neck cancer with various modalities. Dysphagia 292(3):342–351Google Scholar
  4. 4.
    Pandolfino J (2010) High-resolution manometry: is it better for detecting esophageal disease? Gastroenterol Hepatol (NY) 6(10):632–634Google Scholar
  5. 5.
    Dodds W, Kahrilas P, Dent J, Hogan W (1987) Considerations about pharyngeal manometry. Dysphagia 214:209–214CrossRefGoogle Scholar
  6. 6.
    Desuter G, Beguin C, Piessevaux H, Goncette L, Van Parijs V, Van den Bergh P (2009) Physiologic variables for videofluoromanometric assessment of dysphagia: an exploratory study. Acta Gastroenterol Belg 72(3):312–320PubMedGoogle Scholar
  7. 7.
    Rosen SP, Jones CA, Mcculloch TM (2017) Pharyngeal swallowing pressures in the base-of-tongue and hypopharynx regions identified with three-dimensional manometry. Laryngoscope 127(9):1989–1995CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Pursnani KG, Oeffner C, Gideon RM, Castell DO (1997) Comparison of lower oesophageal sphincter pressure measurement using circumferential vs unidirectional transducers. Neurogastroenterol Motil 9(3):177–180CrossRefPubMedGoogle Scholar
  9. 9.
    McConnel FM, Guffin TN, Cerenko D (1991) The effect of asymmetric pharyngoesophageal pressures on manofluorographic measurements. Laryngoscope 101(5):510–515CrossRefPubMedGoogle Scholar
  10. 10.
    Sears VW, Castell JA, Castell DO (1991) Radial and longitudinal asymmetry of human pharyngeal pressures during swallowing. Gastroenterology 101(6):1559–1563CrossRefPubMedGoogle Scholar
  11. 11.
    Castell JA, Castell DO (1993) Modern solid state computerized manometry of the pharyngoesophageal segment. Dysphagia 8(3):270–275CrossRefPubMedGoogle Scholar
  12. 12.
    Robertson EV, Lee YY, Derakhshan MH, Wirz A, Whiting JRH, Seenan JP, Connolly P, Mccoll KE (2012) High-resolution esophageal manometry: addressing thermal drift of the manoscan system. Neurogastroenterol Motil 24(1):61–64CrossRefPubMedGoogle Scholar
  13. 13.
    Lamvik K, Guiu Hernandez E, Jones R, Huckabee M-L (2016) Characterization and correction of pressure drift in the ManoScan TM high-resolution manometry system: in vitro and in vivo. Neurogastroenterol Motil 28(5):732–742CrossRefPubMedGoogle Scholar
  14. 14.
    Huckabee M-L, Lamvik K, Jones R (2014) Pharyngeal mis-sequencing in dysphagia: characteristics, rehabilitative response, and etiological speculation. J Neurol Sci 343(1–2):153–158CrossRefPubMedGoogle Scholar
  15. 15.
    Brasseur J, Dodds W (1991) Interpretation of intraluminal manometric measurements in terms of swallowing mechanics. Dysphagia 6(2):100–119CrossRefPubMedGoogle Scholar
  16. 16.
    Knigge MA, Thibeault S, Mcculloch TM (2014) Implementation of high-resolution manometry in the clinical practice of speech language pathology. Dysphagia 29(1):2–16CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Lamvik K, Jones R, Sauer S, Erfmann K, Huckabee M-L (2015) The capacity for volitional control of pharyngeal swallowing in healthy adults. Physiol Behav 152(Pt A):257–263CrossRefPubMedGoogle Scholar
  18. 18.
    R Foundation for Statistical Computing (2017) R: a language and environment for statistical computing. Vienna, AustriaGoogle Scholar
  19. 19.
    Bates D, Mächler M, Bolker BM, Walker SC (2015) Fitting linear mixed-effects models using lme4. J Stat Softw 2015:67Google Scholar
  20. 20.
    Takasaki K, Umeki H, Enatsu K, Tanaka F, Sakihama N, Kumagami H, Takahashi H (2008) Investigation of pharyngeal swallowing function using high-resolution manometry. Laryngoscope 118(10):1729–1732CrossRefPubMedGoogle Scholar
  21. 21.
    Jones CA, Hammer MJ, Hoffman MR, Mcculloch TM (2014) Quantifying contributions of the cricopharyngeus to upper esophageal sphincter pressure changes by means of intramuscular electromyography and high-resolution manometry. Ann Otol Rhinol Laryngol 123(3):174–182CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Hammer MJ, Jones CA, Mielens JD, Kim CH, Mcculloch TM (2014) Evaluating the tongue-hold maneuver using high-resolution manometry and electromyography. Dysphagia 29(5):564–570CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Kahrilas PJ, Logemann J, Krugler C, Flanagan E (1991) Volitional augmentation of upper esophageal sphincter opening during swallowing. Am J Physiol 260(3 Pt 1):G450–G456PubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Communication DisordersUniversity of CanterburyChristchurchNew Zealand
  2. 2.The Rose Centre for Stroke Recovery and ResearchThe University of CanterburyChristchurchNew Zealand
  3. 3.New Zealand Brain Research InstituteChristchurchNew Zealand
  4. 4.Department of Medical Physics and BioengineeringChristchurch HospitalChristchurchNew Zealand
  5. 5.Department of MedicineUniversity of OtagoChristchurchNew Zealand

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