Journal article
High resolution manometry of pharyngeal swallow pressure events associated with effortful swallow and the Mendelsohn maneuver
Dysphagia, Vol.27(3), pp.418-426
01/04/2012
DOI: 10.1007/s00455-011-9385-6
PMCID: PMC3717357
PMID: 22215280
Abstract
Effortful swallow and the Mendelsohn maneuver are two common strategies to improve disordered swallowing. We used high-resolution manometry (HRM) to quantify the effects of these maneuvers on pressure and timing characteristics. Fourteen normal subjects swallowed multiple, five ml water boluses using three techniques: normal swallow; effortful swallow; and Mendelsohn maneuver. Maximum pressure, rate, duration, area integral, and line integral were determined for the velopharynx and tongue base. Minimum pressure, duration of pressure-related change, duration of nadir pressure, maximum pre-opening and post-closure pressure, area integral, and line integral were recorded for the upper esophageal sphincter (UES). Area and line integrals of the velopharyngeal pressure curve significantly increased with the Mendelsohn maneuver; the line integral increased with the effortful swallow. Pre-opening UES pressure decreased significantly for the Mendelsohn, while post-closure pressure tended to increase insignificantly for both maneuvers. UES area and line integrals as well as nadir UES pressure duration increased with both maneuvers. Maneuver-dependent changes were observed primarily at the velopharynx and UES. These regions are critical to safe swallowing, as the velopharynx provides positive pressure at the bolus tail while the UES allows a bolus to enter the esophagus without risk of regurgitation. Integrals were more responsive than maximum pressure or duration and should be investigated further.
Details
- Title: Subtitle
- High resolution manometry of pharyngeal swallow pressure events associated with effortful swallow and the Mendelsohn maneuver
- Creators
- Matthew R. Hoffman - University of Wisconsin School of Medicine and Public HealthJason D. Mielens - University of Wisconsin–MadisonMichelle R. Ciucci - University of Wisconsin–MadisonCorinne A. Jones - University of Wisconsin–MadisonJack J. Jiang - University of Wisconsin–MadisonTimothy M. McCulloch - University of Wisconsin–Madison
- Resource Type
- Journal article
- Publication Details
- Dysphagia, Vol.27(3), pp.418-426
- DOI
- 10.1007/s00455-011-9385-6
- PMID
- 22215280
- PMCID
- PMC3717357
- ISSN
- 0179-051X
- eISSN
- 1432-0460
- Grant note
- R21 DC011130 || DC / National Institute on Deafness and Other Communication Disorders : NIDCD
- Language
- English
- Date published
- 01/04/2012
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984366373402771
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