Evaluation of Manometric Measures During Tongue-Hold Swallows

Purpose: Based on visual inspection, prior research documented increased movement of the posterior pharyngeal wall in healthy volunteers during tongue-hold swallows. This manometric study investigated the immediate effects of the tongue-hold maneuver on pharyngeal peak pressure generation, duration of pressure generation, and pressure slope measurements in healthy volunteers. Method: Pharyngeal pressures from 40 young, healthy individuals (mean age = 25.8 years, gender equally distributed) were recorded at 3 locations: oropharynx, hypopharynx, and upper esophageal sphincter (UES), during normal control and tongue-hold swallows. Measures of peak amplitude, duration, and slope of pressure generation were subjected to statistical analysis. Results: Tongue-hold swallows produced lower pharyngeal peak pressure and shorter pharyngeal pressure durations compared to control swallows. Further, tongue-hold swallows produced lower UES relaxation pressures. Between sensors, peak pressure was lower and pressure slopes were steeper in the hypopharynx compared to the oropharynx. Several gender-specific differences were found for pharyngeal peak pressure, pressure duration, and pressure slopes. Conclusions: Reduced amplitude and duration of pharyngeal peak pressure is likely a result of decreased base of tongue retraction during tongue-hold swallows. Central clinical considerations and future research directions are discussed in this article.