title: Diagnosis of Swallowing Disorders: How We Interpret Pharyngeal Manometry.
abstract: OBJECTIVE
  We provide an overview of the clinical application of novel pharyngeal high-resolution impedance manometry (HRIM) with pressure flow analysis (PFA) in our hands with example cases.
  
  
  RESULTS
  In our Centre, we base our interpretation of HRIM recordings upon a qualitative assessment of pressure-impedance waveforms during individual swallows, as well as a quantitative assessment of averaged PFA swallow function variables. We provide a description of two global swallowing efficacy measures, the swallow risk index (SRI), reflecting global swallowing dysfunction (higher SRI = greater aspiration risk) and the post-swallow impedance ratio (PSIR) detecting significant post-swallow bolus residue. We describe a further eight swallow function variables specific to the hypopharynx and upper esophageal sphincter (UES), assessing hypo-pharyngeal distension pressure, contractility, bolus presence and flow timing, and UES basal tone, relaxation, opening and contractility. Pharyngeal HRIM has now come of age, being applicable for routine clinical practice to assess the biomechanics of oropharyngeal swallowing dysfunction. In the future, it may guide treatment strategies and allow more objective longitudinal follow-up on clinical outcomes.
authors.affiliation: Gastroenterology & Hepatology, Southern Adelaide Local Health Network, Adelaide, Australia. charles.cock@flinders.edu.au.|Department of Gastroenterology & Hepatology, School of Medicine, Flinders University of South Australia, Flinders Medical Centre, Flinders Drive, Bedford Park, 5042, Australia. charles.cock@flinders.edu.au.
authors.forename: Charles
authors.initials: C
authors.lastname: Cock
authors.affiliation: Department of Gastroenterology & Hepatology, School of Medicine, Flinders University of South Australia, Flinders Medical Centre, Flinders Drive, Bedford Park, 5042, Australia.|Human Physiology, Medical Science and Technology, Flinders University of South Australia, Bedford Park, Australia.
authors.forename: Taher
authors.initials: T
authors.lastname: Omari
mesh_terms: D003680:Deglutition Disorders / Q000175:diagnosis* / Q000503:physiopathology; D017097:Electric Impedance; D049631:Esophageal Sphincter, Upper / Q000503:physiopathology; D006801:Humans; D008365:Manometry / Q000379:methods; D010614:Pharynx / Q000503:physiopathology*; D011312:Pressure; D014783:Viscosity
keywords: Deglutition; Dysphagia; High-resolution manometry; Impedance; Pharynx; Pressure