Logo image
Pharyngeal Swallowing Pressures in Patients with Radiation-Associated Dysphagia
Journal article   Peer reviewed

Pharyngeal Swallowing Pressures in Patients with Radiation-Associated Dysphagia

Nicole E Schaen-Heacock, Corinne A Jones and Timothy M McCulloch
Dysphagia, Vol.36(2), pp.242-249
04/01/2021
DOI: 10.1007/s00455-020-10128-9
PMID: 32415490

View Online

Abstract

Dysphagia associated with radiotherapy for head and neck cancer is complex and can be difficult to treat. Videofluoroscopic swallow studies (VFSS) are the current gold-standard instrumented swallow assessment. High-resolution manometry (HRM) is an additional approach that provides objective measurements of swallowing-related pressures in the pharynx and esophagus. This can provide functional information on the pressure gradients underlying bolus propulsion, and is relevant for this patient population, where radiation-related fibrosis can lead to weakness and impaired pressure generation. The purpose of this preliminary study was to describe pharyngeal swallowing pressures in patients with radiation-associated dysphagia (RAD) and late radiation-associated dysphagia (LRAD) using HRM. RAD occurs during and immediately following treatment, whereas LRAD is a more recently described phenomenon in which the patient experiences an onset of dysphagia at least 5 years post-treatment. We performed a retrospective analysis of pharyngeal swallowing pressures from 21 patients with RAD or LRAD and 21 healthy sex/age-matched controls. Patients with RAD or LRAD exhibited decreased swallowing pressure durations throughout the pharynx (p ≤ 0.002), as well as decreased hypopharynx maximum pressure (p = 0.003) and pharyngeal contractile integral ( p < 0.0001). Understanding how pharyngeal pressure generation is altered in patients with a history of radiotherapy can help clinicians form more precise treatment plans.
Deglutition Deglutition Disorders - etiology Humans Manometry Pharynx Retrospective Studies

Details

Metrics

Logo image