Videofluoroscopic and manometric evaluation of pharyngeal and upper esophageal sphincter function during swallowing.
OBJECTIVE
The purpose of this study was to determine important manometric metrics for the analysis of pharyngeal and upper esophageal sphincter (UES) function and to investigate the effect of viscosity and other confounding factors on manometric results.


METHODS
Manometric studies were performed on 26 asymptomatic volunteers (12 men and 14 women; age, 19-81 years). The manometric protocol included 5 water swallows (5 mL), 5 barium swallows (5 mL) and 5 yogurt swallows (5 mL). Evaluation of high-resolution manometry parameters including basal pressure of the UES, mesopharyngeal contractile integral (mesopharyngeal CI, mmHg · cm · sec), CI of the hypopharynx and UES (hypopharyngeal CI), relaxation interval of UES, median intrabolus pressure and nadir pressure at UES was performed using MATLAB.


RESULTS
Mesopharyngeal CIs for barium and yogurt swallows were significantly lower than those for water swallows (both P < 0.05). Hypopharyngeal CIs for water swallows were significantly lower than those for barium swallows (P = 0.004), and median bolus pressure at UES for barium swallows was significantly higher than that for water and yogurt swallows (both P < 0.05). Furthermore, hypopharyngeal CI and median intrabolus pressure at UES were significantly related to age for 3 swallows (all P < 0.01 and P < 0.05, respectively). A significant negative correlation was also noted between nadir pressure at UES and age for water and yogurt swallows (all P < 0.05).


CONCLUSIONS
Manometric measurement of the pharynx and UES varies with respect to viscosity. Moreover, age could be a confounding variable in the interpretation of pharyngeal manometry.
Departments of Physical and Rehabilitation, Sungkyunkwan University College of Medicine, Seoul, Korea.
Kyung Jae
KJ
Yoon
Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Korea.
Jung Ho
JH
Park
Department of Bionano Technology, Gachon University, Seongnam, Gyeonggi-do, Korea.
Jung Hwan
JH
Park
Department of Bionano Technology, Gachon University, Seongnam, Gyeonggi-do, Korea.
Il Seok
IS
Jung
Manometry, Deglutition, Esophageal sphincter, upper, Fluoroscopy, Pharynx