Pharyngeal and Upper Esophageal Sphincter Manometry in the Evaluation of Dysphagia
Abstract
The use of esophageal manometry seems to be increasing, but the utility of pharyngeal and upper esophageal sphincter (UES) manometry is not widely recognized. This article is intended to clarify this subject. Initially, we review the anatomy and physiology of this area. Most studies indicate that the manometry of the UES and pharynx provides useful information primarily in patients that have symptoms of oropharyngeal dysfunction. Oropharyngeal dysphagia has high morbidity, mortality, and cost. It occurs in one third of all stroke patients and is common in the chronic care setting; up to 60% of nursing home occupants have feeding difficulties, of whom a substantial portion have dysphagia. For patients with oropharyngeal dysphagia, as for those with esophageal dysphagia, barium swallow study and manometry are complimentary. Their combined use permits us to enhance the understanding of the pathophysiologic process that causes the patient's symptoms. Abnormalities have been noted in a variety of diseases, such as Parkinson's disease, oculopharyngeal muscular dystrophy, achalasia, and scleroderma. Thus, it is possible to determine the primary pathology that is causing the patient's dysphagia by analyzing the manometry results. Pharyngeal and UES manometry also has a value in evaluating patients who are candidates for myotomy or dilatation, as it can help identify patients with a prospective good outcome.
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Abnormalities in PES opening are well-suited to examination with manometry.
“Abnormalities in PES opening are well-suited to examination with manometry19,20 and normal opening is easily identified on the HRM spatiotemporal plot as a decrease in pressure at the UES to or below atmospheric pressure.”
From Classification of high-resolution manometry data according to videofluoroscopic parameters using pattern recognition (2013) · cites this paper as [20]
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Ismail, M. K., & Shrestha, S. (2021) · Elsevier eBooks · doi:10.1016/b978-0-323-71317-7.00004-4
Disorders of Sucking and Swallowing
Giugliano, F. P., Miele, E., & Staiano, A. (2021) · Springer eBooks · doi:10.1007/978-3-030-80068-0_20
Pfeiffer, R. F. (2008) · Elsevier eBooks · doi:10.1016/b978-0-7506-7525-3.50016-9
Effets secondaires, complications et séquelles de la chirurgie
(2013) · Elsevier eBooks · doi:10.1016/b978-2-294-73541-7.00003-5
A Review of Related Studies on Hemorrhagic Stroke Complicated with Dysphagia
王, 凡. (2023) · Advances in Clinical Medicine · doi:10.12677/acm.2023.1371650
Update on Cricopharyngeal Dysphagia
Kim, H.-B., & Park, Y.-H. (2023) · Journal of the Korean Dysphagia Society · doi:10.34160/jkds.23.013
- Authors
- Hila, A., Castell, J. A., & Castell, D. O.
- Affiliations
- Graduate Hospital (US)
- Corresponding author
- Castell, June A.
- Castell, Donald O.
- Venue
- Journal of Clinical Gastroenterology
- Published
- 2001-11
- Volume
- 33
- Issue
- 5
- Pages
- 355-361
- ISSN
- 0192-0790 (ISSN-L)
- OpenAlex
- W2038524444
- Cited by
- 72
- References
- 42
- Citations by year
- 2023: 2 · 2022: 3 · 2021: 6 · 2020: 2 · 2019: 4 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 6 · 2014: 1 · 2013: 8 · 2012: 2
- FWCI
- 0.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Surgery › Esophageal and GI Pathology
- Keywords
- pharyngeal manometry, oropharyngeal dysphagia, esophageal dysphagia, barium swallow, stroke, Parkinson's disease, oculopharyngeal muscular dystrophy, achalasia, systemic sclerosis, myotomy, esophageal dilation, esophageal physiology
- MeSH terms
- Deglutition Disorders, Esophagogastric Junction, Humans, Manometry, Pharynx
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