title: Pressure flow analysis in the assessment of preswallow pharyngeal bolus presence in Dysphagia.
abstract: Objectives. Preswallow pharyngeal bolus presence is evident in patients with oropharyngeal dysphagia. Pressure flow analysis (PFA) using high resolution manometry with impedance (HRMI) with AIMplot software is a method for objective interpretation of pharyngeal and upper esophageal sphincter (UES) pressures and bolus flow patterns during swallowing. This study aimed to observe alterations in PFA metrics in the event of preswallow pharyngeal bolus presence as seen on videofluoroscopy (VFSS). Methods. Swallows from 40 broad dysphagia patients and 8 controls were recorded with a HRMI catheter during simultaneous VFSS. Evidence of bolus presence and level reached prior to pharyngeal swallow onset was recorded. AIMPlot software derived automated PFA functional metrics. Results. Patients with bolus movement to the pyriform sinuses had a higher SRI, indicating greater swallow dysfunction. Amongst individual metrics, TNadImp to PeakP was shorter and flow interval longer in patient groups compared to controls. A higher pharyngeal mean impedance and UES mean impedance differentiated the two patient groups. Conclusions. This pilot study identifies specific altered PFA metrics in patients demonstrating preswallow pharyngeal bolus presence to the pyriform sinuses. PFA metrics may be used to guide diagnosis and treatment of patients with oropharyngeal dysphagia and track changes in swallow function over time.
authors.affiliation: Gastroenterology Unit, Child, Youth & Women's Health Service, Adelaide, SA, Australia ; School of Medicine, Flinders University, Adelaide, SA, Australia.
authors.forename: Lara
authors.initials: L
authors.lastname: Ferris
authors.affiliation: Gastroenterology Unit, Child, Youth & Women's Health Service, Adelaide, SA, Australia ; School of Medicine, Flinders University, Adelaide, SA, Australia.
authors.forename: Taher
authors.initials: T
authors.lastname: Omari
authors.affiliation: Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium ; ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium.
authors.forename: Margot
authors.initials: M
authors.lastname: Selleslagh
authors.affiliation: Geriatric Medicine, University Hospital Leuven, Leuven, Belgium ; Center for Swallowing Disorders, University Hospital Leuven, Leuven, Belgium.
authors.forename: Eddy
authors.initials: E
authors.lastname: Dejaeger
authors.affiliation: Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Tack
authors.affiliation: Center for Swallowing Disorders, University Hospital Leuven, Leuven, Belgium ; Radiology, University Hospital Leuven, Leuven, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Vanbeckevoort
authors.affiliation: Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium ; ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rommel