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Journal of Gastrointestinal Surgery

, Volume 19, Issue 10, pp 1753–1757 | Cite as

High-Resolution Manometry Evaluation of the Pharynx and Upper Esophageal Sphincter Motility in Patients with Achalasia

  • Mariano A. Menezes
  • Fernando A. M. Herbella
  • Marco G. Patti
Original Article

Abstract

The motility of the pharynx and upper esophageal sphincter (UES) is still poorly understood. It is also unclear if the motility of this area may be compromised in patients with achalasia. This study aims to evaluate the motility of the pharynx, UES, and proximal esophagus in patients with esophageal achalasia. Sixty patients with achalasia underwent high-resolution manometry (HRM) (52 % females, mean age 54 years). Esophageal dilatation was classified according to the radiologic diameter in Type I (<4 cm): 6 %; Type II (4–7 cm): 36 %; Type III (7–10 cm): 34 %; and Type IV (>10 cm): 24 %. HRM classified 43 % of the patients as Chicago Type I and 57 % as Type II. Manometric parameters were compared to normal values obtained from a previous study in volunteers. The motility of the velopharynx showed short, premature, and hypertonic contraction. The epiglottis also showed hypertonic contraction. The UES had increased residual pressure. Chicago classification Type II patients had higher UES residual pressure (p = 0.03). The degree of esophageal dilatation did not correlate with manometric parameters. Achalasia may affect the motility of the pharyngo-upper esophageal area. The changes observed may represent functional alterations to prevent aspiration, especially in patients with Chicago classification Type II achalasia.

Keywords

Achalasia High-resolution manometry Esophageal motility Pharynx Upper esophageal sphincter 

Notes

Conflict of Interest

Authors declare that they have no competing interests.

Author’s Contribution

MAM and FAMH did the conception and design, acquisition of data, analysis and interpretation of data, drafting the article, and final approval of the version to be published. MGP did the review for intellectual content and final approval of the version to be published.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2015

Authors and Affiliations

  • Mariano A. Menezes
    • 1
  • Fernando A. M. Herbella
    • 1
    • 3
  • Marco G. Patti
    • 2
  1. 1.Department of Surgery, Escola Paulista de MedicinaFederal University of São PauloSão PauloBrazil
  2. 2.Department of SurgeryUniversity of ChicagoChicagoUSA
  3. 3.Department of SurgeryEscola Paulista de MedicinaSao PauloBrazil

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