Advertisement

Manometric Evaluation of Pediatric Swallow

  • Corinne A. JonesEmail author
  • Jesse D. Hoffmeister
Chapter

Abstract

Swallowing involves precise coordination of muscle contractions, resulting in pressure changes that act on oropharyngeal structures as well as the swallowed material. Pharyngeal manometry can measure some of these pressures through the use of a flexible pressure catheter placed transnasally through the pharynx and esophagus. This allows for the objective measurement of swallowing pressures, providing data not obtainable by other evaluation techniques and enabling for straightforward comparisons between healthy and disordered swallowing. This chapter explores indications, techniques, and data output of pharyngeal high-resolution manometry, with special considerations for the pediatric population. Published normative data and future directions for this field are also presented.

Keywords

Swallowing Dysphagia Pressure changes in swallow High-resolution manometry Speech-language pathologist Otolaryngologist Gastroenterologist 

References

  1. 1.
    Dodds WJ, Stewart ET, Logemann JA. Physiology and radiology of the normal oral and pharyngeal phases of swallowing. Am J Roentgenol. 1990;154(5):953–63.CrossRefGoogle Scholar
  2. 2.
    Baijens LW, Barikroo A, Pilz W. Intrarater and interrater reliability for measurements in videofluoroscopy of swallowing. Eur J Radiol. 2013;82(10):1683–95.CrossRefGoogle Scholar
  3. 3.
    Fox MR, Bredenoord AJ. Oesophageal high-resolution manometry: moving from research into clinical practice. Gut. 2008;57(3):405–23.CrossRefGoogle Scholar
  4. 4.
    Rommel N, Omari T. The use of high resolution manometry for the assessment of swallowing in infants and young children. B-ENT. 2008;4:27–39.Google Scholar
  5. 5.
    Gilger MA, Boyle JT, Sondheimer JM, Colletti RB. A medical position statement of the North American Society for Pediatric Gastroenterology and Nutrition: indications for pediatric esophageal manometry. J Pediatr Gastroenterol Nutr. 1997;24(5):616–8.CrossRefGoogle Scholar
  6. 6.
    Hoffman MR, Ciucci MR, Mielens JD, Jiang JJ, McCulloch TM. Pharyngeal swallow adaptations to bolus volume measured with high-resolution manometry. Laryngoscope. 2010;120(12):2367–73.CrossRefGoogle Scholar
  7. 7.
    McCulloch TM, Hoffman MR, Ciucci MR. High-resolution manometry of pharyngeal swallow pressure events associated with head turn and chin tuck. Ann Otol Rhinol Laryngol. 2010;119(6):369–76.CrossRefGoogle Scholar
  8. 8.
    Cock C, Jones CA, Hammer MJ, Omari TI, McCulloch TM. Modulation of upper esophageal sphincter (UES) relaxation and opening during volume swallowing. Dysphagia. 2017;32(2):216–24.CrossRefGoogle Scholar
  9. 9.
    Omari TI, Dejaeger E, Van Beckevoort D, Goeleven A, De Cock P, Hoffman I, et al. A novel method for the nonradiological assessment of ineffective swallowing. Am J Gastroenterol. 2011;106(10):1796–802.CrossRefGoogle Scholar
  10. 10.
    Meyer JP, Jones CA, Walczak CC, McCulloch TM. Three-dimensional manometry of the upper esophageal sphincter in swallowing and nonswallowing tasks. Laryngoscope. 2016;126(11):2539–45.CrossRefGoogle Scholar
  11. 11.
    Rosen SP, Jones CA, McCulloch TM. Pharyngeal swallowing pressures in the base-of-tongue and hypopharynx regions identified with three-dimensional manometry. Laryngoscope. 2017;127(9):1989–95.CrossRefGoogle Scholar
  12. 12.
    Knigge MA, Thibeault S. Relationship between tongue base region pressures and vallecular clearance. Dysphagia. 2016;31(3):391–7.CrossRefGoogle Scholar
  13. 13.
    Cock C, Omari T. Diagnosis of swallowing disorders: how we interpret pharyngeal manometry. Curr Gastroenterol Rep. 2017;19(3):11.CrossRefGoogle Scholar
  14. 14.
    Goldani HA, Staiano A, Borrelli O, Thapar N, Lindley KJ. Pediatric esophageal high-resolution manometry: utility of a standardized protocol and size-adjusted pressure topography parameters. Am J Gastroenterol. 2010;105(2):460–7.CrossRefGoogle Scholar
  15. 15.
    Kahrilas PJ, Bredenoord AJ, Fox M, Gyawali CP, Roman S, Smout AJ, et al. The Chicago Classification of esophageal motility disorders, v3.0. Neurogastroenterol Motil. 2015;27(2):160–74.CrossRefGoogle Scholar
  16. 16.
    Knigge MA, Thibeault S, McCulloch TM. Implementation of high-resolution manometry in the clinical practice of speech language pathology. Dysphagia. 2014;29(1):2–16.CrossRefGoogle Scholar
  17. 17.
    Reynolds J, Carroll S, Sturdivant C. Fiberoptic endoscopic evaluation of swallowing: a multidisciplinary alternative for assessment of infants with dysphagia in the neonatal intensive care unit. Adv Neonatal Care. 2016;16(1):37–43.CrossRefGoogle Scholar
  18. 18.
    Hong J. Clinical applications of gastrointestinal manometry in children. Pediatr Gastroenterol Hepatol Nutr. 2014;17(1):23–30.CrossRefGoogle Scholar
  19. 19.
    Geng Z, Hoffman MR, Jones CA, McCulloch TM, Jiang JJ. Three-dimensional analysis of pharyngeal high-resolution manometry data. Laryngoscope. 2013;123(7):1746–53.CrossRefGoogle Scholar
  20. 20.
    Ghosh SK, Pandolfino JE, Zhang Q, Jarosz A, Kahrilas PJ. Deglutitive upper esophageal sphincter relaxation: a study of 75 volunteer subjects using solid-state high-resolution manometry. Am J Physiol-Gastrointest Liver Physiol. 2006;291(3):G525–G31.CrossRefGoogle Scholar
  21. 21.
    Jones CA, Ciucci MR, Hammer MJ, McCulloch TM. A multisensor approach to improve manometric analysis of the upper esophageal sphincter. Laryngoscope. 2016;126(3):657–64.CrossRefGoogle Scholar
  22. 22.
    Rommel N, van Wijk M, Boets B, Hebbard G, Haslam R, Davidson G, et al. Development of pharyngo-esophageal physiology during swallowing in the preterm infant. Neurogastroenterol Motil. 2011;23(10):e401–8.CrossRefGoogle Scholar
  23. 23.
    Ferris L, Rommel N, Doeltgen S, Scholten I, Kritas S, Abu-Assi R, et al. Pressure-flow analysis for the assessment of pediatric oropharyngeal dysphagia. J Pediatr. 2016;177:279–85.e1.CrossRefGoogle Scholar
  24. 24.
    Ferris L, King S, McCall L, Rommel N, Scholten I, Teague W, et al. Piecemeal deglutition and the implications for pressure impedance dysphagia assessment in pediatrics. J Pediatr Gastroenterol Nutr. 2018;67(6):713–9.CrossRefGoogle Scholar
  25. 25.
    Jadcherla SR, Prabhakar V, Hasenstab KA, Nawaz S, Das J, Kern M, et al. Defining pharyngeal contractile integral during high-resolution manometry in neonates: a neuromotor marker of pharyngeal vigor. Pediatr Res. 2018;84(3):341–7.CrossRefGoogle Scholar
  26. 26.
    Rommel N, Omari TI, Selleslagh M, Kritas S, Cock C, Rosan R, et al. High-resolution manometry combined with impedance measurements discriminates the cause of dysphagia in children. Eur J Pediatr. 2015;174(12):1629–37.CrossRefGoogle Scholar
  27. 27.
    Rosen SP, Abdelhalim SM, Jones CA, McCulloch TM. Effect of body position on pharyngeal swallowing pressures using high-resolution manometry. Dysphagia. 2018;33(3):389–98.CrossRefGoogle Scholar
  28. 28.
    Omari TI, Ferris L, Dejaeger E, Tack JF, Vanbeckevoort D, Rommel N. Upper esophageal sphincter impedance as a marker of sphincter opening diameter. Am J Physiol Gastrointest Liver Physiol. 2012;302(9):G909–G13.CrossRefGoogle Scholar
  29. 29.
    Omari TI, Dejaeger E, Tack J, Vanbeckevoort D, Rommel N. An impedance-manometry based method for non-radiological detection of pharyngeal postswallow residue. Neurogastroenterol Motil. 2012;24(7):e277–e84.CrossRefGoogle Scholar
  30. 30.
    The Child Life Profession: Association of Child Life Professionals; 2018. Available from: https://www.childlife.org/the-child-life-profession.
  31. 31.
    Panella JJ. Preoperative care of children: strategies from a child life perspective. AORN J. 2016;104(1):11–22.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.NeurologyDell Medical School at the University of Texas-AustinAustinUSA
  2. 2.Department of Communication Sciences and Disorders, Department of Surgery, Division of Otolaryngology-Head and Neck SurgeryUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA

Personalised recommendations