Three-dimensional manometry of the upper esophageal sphincter in swallowing and nonswallowing tasks

Jacob P Meyer; Corinne A Jones; Chelsea C Walczak; Timothy M McCulloch

doi:10.1002/lary.25957

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Three-dimensional manometry of the upper esophageal sphincter in swallowing and nonswallowing tasks

Journal article

Peer reviewed

Three-dimensional manometry of the upper esophageal sphincter in swallowing and nonswallowing tasks

Jacob P Meyer, Corinne A Jones, Chelsea C Walczak and Timothy M McCulloch

The Laryngoscope, Vol.126(11), pp.2539-2545

11/2016

DOI: 10.1002/lary.25957

PMID: 26990011

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Abstract

High-resolution manometry (HRM) is useful in identifying disordered swallowing patterns and quantifying pharyngeal and upper esophageal sphincter (UES) physiology. HRM is limited by unidirectional sensors and circumferential averaging of pressures, resulting in an imperfect understanding of pressure from asymmetrical pharyngeal anatomy. This study aims to evaluate UES pressures simultaneously from different axial directions. Case series. Three-dimensional HRM was performed on eight healthy subjects to evaluate circumferential UES pressure patterns at rest, during the Valsalva maneuver, and during water swallowing. Multivariate analysis of the variance revealed a significant main effect of circumferential direction on pressure while at rest (P < .001); pressure was greater in the anterior and posterior portions of the UES versus lateral portions. A significant main effect of direction on pressure was not found during the Valsalva maneuver. During swallowing of a 5-mL water bolus, circumferential direction had a significant main effect on pressure immediately before UES pressure dropped (P = .001), while the UES was open (P = .01) and at UES closure (P < .001). There was also a significant main effect of sensor level along the vertical axis on pressure immediately before UES pressure dropped (P = .032) and at UES closure (P < .001). Anterior and posterior pressures were again greater than lateral pressures at all swallowing events. These results confirm that UES pressures vary significantly based on their circumferential origin, with the majority of the total pressure generated in anterior and posterior regions. Improved understanding of UES pressure in a three-dimensional space can lead to more sophisticated treatments for pharyngeal and UES dysfunction. 4. Laryngoscope, 126:2539-2545, 2016.

Adult

Deglutition - physiology

Deglutition Disorders - physiopathology

Esophageal Sphincter, Upper - physiology

Female

Healthy Volunteers

Humans

Male

Manometry - methods

Multivariate Analysis

Pharynx - physiology

Pressure

Valsalva Maneuver - physiology

Young Adult

Details

Title: Subtitle: Three-dimensional manometry of the upper esophageal sphincter in swallowing and nonswallowing tasks
Creators: Jacob P Meyer - University of Wisconsin–Madison
Corinne A Jones - University of Wisconsin–Madison
Chelsea C Walczak - University of Wisconsin–Madison
Timothy M McCulloch - University of Wisconsin–Madison
Resource Type: Journal article
Publication Details: The Laryngoscope, Vol.126(11), pp.2539-2545
DOI: 10.1002/lary.25957
PMID: 26990011
ISSN: 0023-852X
eISSN: 1531-4995
Grant note: T32 GM007507 / NIGMS NIH HHS R21 DC011130 / NIDCD NIH HHS
Language: English
Date published: 11/2016
Academic Unit: Communication Sciences and Disorders
Record Identifier: 9985217031802771

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