Pharyngeal solid-state manometry catheter movement during swallowing in dysphagic and nondysphagic participants.
OBJECTIVE
The movements of the soft palate and the larynx are crucial in pharyngeal manometry because of the potential risk of manometry sensor dislocation.


METHODS
Twenty dysphagic patients and 20 nondysphagic volunteers were examined with simultaneous videoradiography and intraluminal pharyngeal solid-state manometry. The movements of the manometric sensors were analyzed from lateral videorecording.


RESULTS
Two different types of catheter movement were found. The sensor in the upper esophageal sphincter (UES) could either be lifted cranially during the closure of the soft palate (type 1) or stay unaltered in the sphincter until the beginning of the laryngeal elevation and then follow the sphincter cranially during laryngeal elevation with no previous response to soft palate closure (type 2). Type 1 movement was found in eight of 20 patients but in only one of the 20 volunteers. The resting pressure of the upper esophageal sphincter was significantly higher in type 2 (P = 0.004). Nineteen of the 20 patients with a high resting pressure of the UES (83+ mm Hg) were found to have the type 2 movement.


CONCLUSIONS
High resting pressure in the UES permitted the sphincter to grasp the manometry catheter and caused the sensor to follow the cranial movement during laryngeal elevation. Sensor movement is important during pharyngeal manometry, and sensor dislocation out of the sphincter can be misinterpreted as sphincter relaxation. Simultaneous videoradiography provides control of sensor positioning and allows for correction.
Olsson
R
R
Department of Diagnostic Radiology, University of Lund, Malmö General Hospital, Sweden.
Nilsson
H
H
Ekberg
O
O
D000328:Adult; D002404:Catheterization / Q000295:instrumentation / Q000379:methods; D003679:Deglutition; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004947:Esophagus / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008365:Manometry / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D010160:Palate, Soft / Q000000981:diagnostic imaging / Q000503:physiopathology; D010614:Pharynx / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014741:Video Recording