Skip to main content
SpringerLink
Log in

High-Resolution Manometry

  • Chapter
  • First Online:
Neurologic and Neurodegenerative Diseases of the Larynx

Abstract

Clinical evaluation and treatment for swallowing disorders has historically relied on subjective judgments of imaging studies, contributing to highly variable interpretation of physiologic events. Technologic advancements in manometry systems have introduced high-resolution manometry as a complementary assessment and treatment tool in complex pharyngeal dysphagia. This chapter will acquaint the reader with high-resolution manometry, outline the evidence supporting its use in pharyngeal dysphagia, define a practice model for clinical application, and propose neurologic conditions where high-resolution pharyngeal manometry can enhance both evaluation and treatment of neurogenic dysphagia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Jones CA, Knigge MA, McCulloch TM. Speech pathologist practice patterns for evaluation and management of suspected cricopharyngeal dysfunction. Dysphagia. 2014;29(3):332–9.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Knigge MA, Thibeault ST, McCulloch TM. Implementation of high-resolution manometry in the practice of speech language pathology. Dysphagia. 2014;29(1):2–16.

    Article  PubMed  PubMed Central  Google Scholar 

  3. O’Rourke A, Humphries K. The use of high-resolution pharyngeal manometry as biofeedback in dysphagia therapy. Ear Nose Throat J. 2017;96(2):56–8.

    Article  PubMed  Google Scholar 

  4. Cock C, Omari T. Diagnosis of swallowing disorders: how we interpret pharyngeal manometry. Curr Gastroenterol Rep. 2017;19(3):11.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Leder SB, Joe JK, Hill SE, Traube M. Effect of tracheotomy tube occlusion on upper esophageal sphincter and pharyngeal pressures in aspirating and nonaspirating patients. Dysphagia. 2001;16(2):79–82.

    Article  CAS  PubMed  Google Scholar 

  6. Butler SG, Stuart A, Kemp S. Flexible endoscopic evaluation of swallowing in healthy young and older adults. Ann Otol Rhinol Laryngol. 2009;118(2):99–106.

    Article  PubMed  Google Scholar 

  7. Butler SG, Stuart A, Markley L, Rees C. Penetration and aspiration in healthy older adults as assessed during endoscopic evaluation of swallowing. Ann Otol Rhinol Laryngol. 2009;118(3):190–8.

    Article  PubMed  Google Scholar 

  8. Lee TH, Lee JS, Hong SJ, Lee JS, Jeon SR, Kim WJ, Kim HG. Impedance analysis using high-resolution impedance manometry facilitates assessment of pharyngeal residue in patients with oropharyngeal dysphagia. J Neurogastroenterol Motil. 2014;20(3):362–70.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Karaho T, Satoh T, Nakajima J, Nakayama T, Kohno N. Can mano-videoendoscopy substitute for videofluorography in evaluation of upper esophageal sphincter function? Acta Otolaryngol. 2015;135(2):187–92.

    Article  PubMed  Google Scholar 

  10. Knigge MA, Marvin S, Thibeault SL. Safety and tolerability of pharyngeal high-resolution manometry. Am J Speech Lang Pathol. 2018; https://doi.org/10.1044/2018_AJSLP-18-0039. [Epub ahead of print].

    Article  PubMed  Google Scholar 

  11. Hernandez EG, Gozdzikowska K, Apperley O, Huckabee M. Effect of topical nasal anesthetic on swallowing in healthy adults: a double-blind, high-resolution manometry study. Laryngoscope. 2018;128(6):1335–9.

    Article  Google Scholar 

  12. Hoffman MR, Ciucci MR, Mielens JD, Jiang JJ, McCulloch TM. Pharyngeal swallow adaptations to bolus volume measured with high-resolution manometry. Larygoscope. 2010;120(12):2367–73.

    Article  Google Scholar 

  13. Nativ-Zeltzer N, Logemann JA, Zecker SG, Kahrilas PJ. Pressure topography metrics for high-resolution pharyngeal-esophageal manofluorography – a normative study of younger and older adults. Neurogastroenterol Motil. 2016;28(5):721–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Omari TI, Kristas S, Cock C, Besanko L, Burgstad C, Thompson A, Rommel N. Swallowing dysfunction in healthy older people using pharyngeal pressure-flow analysis. Neurogastroenterol Motil. 2014;26(1):59–68.

    Article  CAS  PubMed  Google Scholar 

  15. Lamvik K, Jones R, Sauer S, Erfmann K, Huckabee M. The capacity for volitional control of pharyngeal swallowing in healthy adults. Physiol Behav. 2015;152(Pt A):257–63.

    Article  CAS  PubMed  Google Scholar 

  16. Huckabee M, Lamvik K, Jones R. Pharyngeal mis-sequencing in dysphagia: characteristics, rehabilitative response, and etiological speculation. J Neurol Sci. 2014;343(1–2):153–8.

    Article  CAS  PubMed  Google Scholar 

  17. McCulloch T, Hoffman M, Ciucci M. High resolution manometry of pharyngeal swallow pressure events associated with head turn and chin tuck. Ann Otol Rhinol Laryngol. 2010;119(6):369–76.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Hoffman M, Mielens J, Ciucci M, Jones C, Jiang J, McCulloch T. High-resolution manometry of pharyngeal swallow pressure events associated with effortful swallow and the Mendelsohn maneuver. Dysphagia. 2012;27(3):418–26.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Arnold M, Liesirova K, Broeg-Morvay A, Meisterernst J, Schlager M, Mono M, El-Koussy M. Dysphagia in acute stroke: incidence, burden and impact on clinical outcome. PLoS One. 2016;11(2):e0148424.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  20. Lazarus CL, Logemann JA, Rademaker AW, Kahrilas PJ, Pajak T, Lazar R, Halper A. Effects of bolus volume, viscosity, and repeated swallows in nonstroke subjects and stroke patients. Arch Phys Med Rehabil. 1993;74(10):1066–70.

    Article  CAS  PubMed  Google Scholar 

  21. Oommen ER, Kim Y, McCullough G. Stage transition and laryngeal closure in poststroke patients with dysphagia. Dysphagia. 2011;26(3):318–23.

    Article  PubMed  Google Scholar 

  22. Kim Y, Park T, Oommen E, McCullough G. Upper esophageal sphincter opening during swallow in stroke survivors. Am J Phys Med Rehabil. 2015;94(9):734–9.

    Article  PubMed  Google Scholar 

  23. Kim H, Lee HJ, Park JW. Clinical course and outcome in patients with severe dysphagia after lateral medullary syndrome. Ther Adv Neurol Disord. 2018;11:1756286418759864.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Lee T, Park JH, Sohn C, Yoon KJ, Lee Y, Park JH, Jung IS. Failed deglutitive upper esophageal sphincter relaxation is a risk factor for aspiration in stroke patients with oropharyngeal dysphagia. J Neurogastroenterol Motil. 2017;23(1):34–40.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Vuilleumier P, Bogousslavsky J, Regli F. Infarction of the lower brainstem: clinical, aetiological and MRI- topographical correlations. Brain. 1995;118(Pt 4):1013–25.

    Article  PubMed  Google Scholar 

  26. Ogawa K, Suzuki Y, Oishi M, Kamei S. Clinical study of 46 patients with lateral medullary infarction. J Stroke Cerbrovasc Dis. 2015;24(5):1065–74.

    Article  Google Scholar 

  27. Higo R, Tayama N, Watanabe T. Manometric abnormality in dysphagic patients after medullary cerebrovascular accidents. ORL J Otorhinolaryngol Relat Spec. 2002;64(5):368–72.

    Article  PubMed  Google Scholar 

  28. Williams RBH, Wallace KL, Ali GN, Cook IJ. Biomechanics of failed Deglutitive upper esophageal sphincter relaxation in neurogenic dysphagia. Am J Physiol Gastrointest Liver Physiol. 2002;283:G16–26.

    Article  CAS  PubMed  Google Scholar 

  29. Chiu M, Chang Y, Hsiao T. Prolonged effect of botulinum toxin injection in the treatment of cricopharyngeal dysphagia: case report and literature review. Dysphagia. 2004;19:52–7.

    Article  PubMed  Google Scholar 

  30. Masiero S, Briani C, Marchese-Ragona R, Giacometti P, Constantini M, Zaninotto G. Successful treatment of long-standing post-stroke dysphagia with botulinum toxin and rehabilitation. J Rehabil Med. 2006;38:201–3.

    Article  PubMed  Google Scholar 

  31. Ali GN, Wallace KL, Laundl TM, Hunt DR, deCarle DJ, Cook IJ. Predictors of outcome following cricopharyngeal disruption for pharyngeal dysphagia. Dysphagia. 1997;12:133–9.

    Article  CAS  PubMed  Google Scholar 

  32. Pal A, Williams RB, Cook IJ, Brasseur JG. Intrabolus pressure gradient identifies pathological constriction in the upper esophageal sphincter during flow. Am J Physiol Gastrointest Liver Physiol. 2003;285:G1037–48.

    Article  CAS  PubMed  Google Scholar 

  33. Ozgursoy OB, Salassa JR. Manofluorographic and functional outcomes after endoscopic laser cricopharyngeal myotomy for cricopharyngeal bar. J Otolaryngol Head Neck Surg. 2010;142:735–40.

    Article  Google Scholar 

  34. Ozgursoy OB, Salassa JR. Functional and manofluorographic outcomes after transoral endoscopic pharyngoesophageal diverticulostomy. Arch Otolaryngol Head Neck Surg. 2010;136(5):463–7.

    Article  PubMed  Google Scholar 

  35. Szczesniak MM, Wu PI, Maclean J, Omari TI, Cook IJ. The critical importance of pharyngeal contractile forces on the validity of intrabolus pressure as a predictor of impaired pharyngo-esophageal junction compliance. Neurogastroenterol Motil. 2018;30:e13374.

    Article  CAS  PubMed  Google Scholar 

  36. Hurwitz AL, Nelson JA, Haddad JK. Oropharyngeal dysphagia: manometric and cine esophagographic findings. Dig Dis. 1975;20(4):313–24.

    Article  CAS  Google Scholar 

  37. Castell JA, Castell DO, Duranceau A, Topart P. Manometric characteristics of the pharynx, upper esophageal sphincter, esophagus, and lower esophageal sphincter in patients with oculopharyngeal muscular dystrophy. Dysphagia. 1995;10(1):22–6.

    Article  CAS  PubMed  Google Scholar 

  38. Bellini M, Biagi S, Stasi C, Costa F, Mumolo MG, Ricchiuti A, Marchi S. Gastrointestinal manifestations in myotonic muscular dystrophy. World J Gastroenterol. 2006;12(12):1821–8.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Stübgen J. Limb girdle muscular dystrophy: a radiologic and manometric study of the pharynx and esophagus. Dysphagia. 1996;11(1):25–9.

    Article  PubMed  Google Scholar 

  40. Stübgen J. Facioscapulohumeral muscular dystrophy: a radiologic and manometric study of the pharynx and esophagus. Dysphagia. 2008;23(4):341–7.

    Article  PubMed  Google Scholar 

  41. Duranceau A. Cricopharyngeal myotomy in the management and treatment of neurogenic and muscular dysphagia. Neuromuscul Disord. 1997;7(Suppl 1):S85–9.

    Article  PubMed  Google Scholar 

  42. Périé S, Eymard B, Laccourreye L, Chaussade S, Fardeau M, St Guily JL. Dysphagia in oculopharyngeal muscular dystrophy: a series of 22 French cases. Neuromuscul Disord. 1997;7(Suppl 1):S96–9.

    Article  PubMed  Google Scholar 

  43. Tomik J, Tomik B, Gajec S, Ceranowicz P, Pihut M, Olszanecki R, Strek P. The balloon-based manometry evaluation of swallowing in patients with amyotrophic lateral sclerosis. Int J Mol Sci. 2017;18(4). pii: E707.

    Article  PubMed Central  Google Scholar 

  44. Rubin AD, Griffin GR, Hogikyan ND, Feldman EL. A new member of the multidisciplinary ALS team: the otolaryngologist. Amyotroph Lateral Scler. 2012;13(2):229–32.

    Article  PubMed  Google Scholar 

  45. Harrison L, Wills A, Beasley N. Diagnosing amyotrophic lateral sclerosis (ALS) in ENT. Clin Otolaryngol. 38(6):564–5.

    Article  CAS  PubMed  Google Scholar 

  46. Broussalis E, Grinzinger S, Kunz AB, Killer-Oberpfalzer M, Haschke-Becher E, Hartung HP, Kraus J. Late age onset of amyotrophic lateral sclerosis is often not considered in elderly people. Acta Neurol Scand. 2018;137(3):329–34.

    Article  CAS  PubMed  Google Scholar 

  47. Easterling C, Antinoja J, Cashin S. Changes in tongue pressure, pulmonary function and salivary flow in patients with amyotrophic lateral sclerosis. Dysphagia. 2013;28(2):217–25.

    Article  PubMed  Google Scholar 

  48. Hiraoka A, Yoshikawa M, Nakamori M, Hosomi N, Nagasaki T, Mori T, Oda M. Maximum tongue pressure is associated with swallowing dysfunction in ALS patients. Dysphagia. 2017;32(4):542–7.

    Article  PubMed  Google Scholar 

  49. Fattori B, Siciliano G, Mancini V, Bastiani L, Bongioanni P, Ienco EC, Barillari MR. Dysphagia in amyotrophic lateral sclerosis: relationships between disease progression and fiberoptic endoscopic evaluation of swallowing. Auris Nasus Larynx. 2017;44(3):306–12.

    Article  PubMed  Google Scholar 

  50. Solazzo A, Monaco L, Del Vecchio L, Reginelli A, Iacobellis F, Capasso R, Tamburrini S. Earliest videofluoromanometric pharyngeal signs of dysphagia in ALS patients. Dysphagia. 2014;29(5):539–44.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Otolaryngology–Head & Neck Surgery, Department of Surgery & Department of Communication Sciences and Disorders, University of Wisconsin–Madison, Clinical Science Center, Madison, WI, USA

    Timothy M. McCulloch

  2. Division of Otolaryngology–Head & Neck Surgery, Department of Surgery, University of Wisconsin–Madison, Madison, WI, USA

    Molly A. Knigge

Authors
  1. Timothy M. McCulloch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Molly A. Knigge
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Timothy M. McCulloch .

Editor information

Editors and Affiliations

  1. Division of Otolaryngology–Head & Neck Surgery, Department of Surgery, University of California San Diego, La Jolla, CA, USA

    Philip A. Weissbrod

  2. Division of Otolaryngology–Head & Neck Surgery, Department of Surgery, University of Wisconsin–Madison, Madison, WI, USA

    David O. Francis

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

McCulloch, T.M., Knigge, M.A. (2020). High-Resolution Manometry. In: Weissbrod, P., Francis, D. (eds) Neurologic and Neurodegenerative Diseases of the Larynx. Springer, Cham. https://doi.org/10.1007/978-3-030-28852-5_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-28852-5_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-28851-8

  • Online ISBN: 978-3-030-28852-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation