Original researchFindings of Abnormal Videofluoroscopic Swallowing Study Identified by High-Resolution Manometry Parameters
Section snippets
Participants
This study was a prospective observational study conducted from August 11, 2014, to November 31, 2014. Forty patients were enrolled, including both inpatients and outpatients, who had dysphagia symptoms with stable vital signs; they were all physically able to participate in the study, providing consent to participate. Patients with dysphagia reported at least 1 symptom of dysphagia (eg, food sticking, cough with eating, globus sensation, diet change). The following patients were excluded:
Findings of VFSS
Among the 40 participants, 16 showed delayed swallowing reflex and impaired laryngeal elevation. Moreover, supraglottic penetration was observed in 4 subjects, and subglottic aspiration was observed in 18 subjects (see table 2).
Significant HRM variables according to VFSS parameters
Variables with highly positive prediction in a univariate logistic analysis are listed on table 3 (P<.05). The maximum VP pressure showed a significant positive prediction for most abnormal parameters of VFSS in the pharyngeal phase. Nadir UES pressure duration was
Discussion
Safe swallowing requires precise coordination of neuromuscular events to generate pressure gradients that propel a bolus from the mouth to the esophagus.9, 21, 22, 23 An inability to generate adequate oropharyngeal pressure has been correlated with dysphagia.9, 24 The purpose of this study was to identify the correlations between dysphagia and sequential pharyngeal pressure events. Therefore, we compared the HRM parameters with abnormalities visible in VFSS. By making such a comparison, we
Conclusions
Because the movement of swallowing is mediated by several important muscular contractions that generate pressure, muscular weakness of pharyngeal structure might be one of the most important mechanisms for developing dysphagia. In this study, we found that significant HRM parameters are highly specific to abnormal findings of VFSS. We suggested the cutoff value, sensitivity, and specificity for these findings. Because HRM could inform the quantitative measurement of pharyngeal weakness, the
Suppliers
- a.
Sandhill Scientific Instruments.
- b.
SPSS for Windows version 21.0; SPSS.
- c.
R package for Windows version 2.15.2; R Foundation for Statistical Computing.
References (32)
- et al.
Effects of a tongue-holding maneuver during swallowing evaluated by high-resolution manometry
Otolaryngol Head Neck Surg
(2009) - et al.
Dysphagia dietary guidelines and the rheology of nutritional feeds and barium test feeds
Chest
(2008) Normal and disordered swallowing: new insights
Baillieres Clin Gastroenterol
(1991)- et al.
A method to objectively assess swallow function in adults with suspected aspiration
Gastroenterology
(2011) - et al.
Upper esophageal sphincter opening and modulation during swallowing
Gastroenterology
(1989) - et al.
Changes of timing variables in swallowing of boluses with different viscosities in patients with dysphagia
Arch Phys Med Rehabil
(2013) - et al.
The correlation between manometric and videofluoroscopic measurements of the swallowing function in brainstem stroke patients with dysphagia
J Clin Gastroenterol
(2015) - et al.
Timing of major events of pharyngeal swallowing
Arch Otolaryngol Head Neck Surg
(1988) - et al.
Classification of high-resolution manometry data according to videofluoroscopic parameters using pattern recognition
Otolaryngol Head Neck Surg
(2013) - et al.
Effects of age, gender, bolus condition, viscosity, and volume on pharyngeal and upper esophageal sphincter pressure and temporal measurements during swallowing
J Speech Lang Hear Res
(2009)
Effects of age, gender, bolus volume, and bolus viscosity on oropharyngeal pressure during swallowing
J Appl Physiol (1985)
Effect of swallowed bolus variables on oral and pharyngeal phases of swallowing
Am J Physiol
Three-dimensional analysis of pharyngeal high-resolution manometry data
Laryngoscope
The upper esophageal sphincter during normal deglutition. A simultaneous cineradiographic and manometric investigation
Acta Radiol Diagn (Stockh)
Automated analysis of pharyngeal pressure data obtained with high-resolution manometry
Dysphagia
Oesophageal high-resolution manometry: moving from research into clinical practice
Gut
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Supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, Information/Communication Technology and Future Planning (grant no. NRF-2013R1A1A1004622).
Disclosures: none.