Biofeedback Training Improves Swallowing in a Unique Case of Upper Esophageal Sphincter Hypotonicity

Hypotonicity of the upper esophageal sphincter (UES) has been reported only two times previously in the literature, with no reports of treatment options for this rarity. We present a third case of hypotonic UES found during high-resolution pharyngeal manometry. Although the patient had nearly absent resting pressures of the UES, pressures during and post-swallow were normal. It was hypothesized that the patient might be able to increase pre-swallow UES pressure using biofeedback. Using a chin up/out maneuver during manometry, the patient was able to achieve a more normal swallow pressure pattern. This case also highlights the need to complete manometry alongside other swallow imaging techniques for effective treatment planning and patient outcomes. Laryngoscope, 2020

Automated summary

This study presented a rare case of hypotonic upper esophageal sphincter (UES), with the patient able to achieve a more normal swallow pressure pattern using biofeedback and a specific maneuver during manometry. It also highlighted the importance of combining manometry with other swallow imaging techniques for effective treatment planning and patient outcomes.