期刊
ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY
卷 119, 期 6, 页码 369-376出版社
ANNALS PUBL CO
DOI: 10.1177/000348941011900602
关键词
dysphagia; high-resolution manometry; pharyngeal pressure; swallowing maneuver
资金
- NIDCD NIH HHS [P30 DC010754, P30 DC010754-01, R33 DC011130] Funding Source: Medline
Objectives: We quantified the effect of swallowing maneuvers on pharyngeal pressure events using high-resolution manometry. Methods: Seven subjects swallowed multiple 5-mL water boluses in 3 different postural conditions: neutral, head turn. and chin tuck. Pressure and timing events were recorded with a 36-sensor high-resolution manometry catheter. We analyzed the regions of the velopharynx and the base of the tongue for maximum pressure. rate of pressure increase, pressure gradient, and duration of pressure above baseline. In the region of the upper esophageal sphincter (UES), we analyzed the duration of pressure declination, minimum pressure during UES opening, and maximum pressures before and alter LIES opening. Results: The maneuvers did not have a significant effect on maximum pressure, rate of pressure increase, or pressure gradients in the velopharyngeal or tongue base regions. The duration of pressure above baseline was significantly longer in the velopharynx for head turn. The preswallow maximum LIES pressure was significantly greater for neutral swallows than for head turn, and the postswallow maximum pressure was significantly lower for chin tuck. Both mane users appeared to prolong LIES pressure declination duration, but neither prolongation reached significance. Conclusions: High-resolution manometry allows for optimal spatial and temporal resolution during recording of pressure events along the length of the pharynx, and revealed previously undetected task-dependent pressure and timing differences during chin tuck and head turn in healthy adults. These maneuvers appear to influence the UES to a greater degree than the velopharynx or the tongue base. Further studies designed to quantify the effect of other maneuvers and bolus consistencies on the generation of pharyngeal pressure events both in normal and in disordered subjects may lead to hypothesis-driven, optimal, individualized swallowing therapies.
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