Effect of bolus volume on pharyngeal swallowing assessed by high-resolution manometry.

Solid-state high-resolution manometry (HRM) is fast becoming the gold standard for studying pharyngeal and esophageal motility. However, very few studies have ever evaluated the effect of bolus volume on the physiology of swallowing using HRM. We aimed to determine the effect of bolus volume on pressure, duration and velocity of the hypopharynx as well as the upper esophageal sphincter during pharyngeal swallowing using HRM. Thirty-four healthy subjects completed nine swallows (3 ml, 5 ml and 10 ml of water, thick liquid, and paste, respectively) in the natural sitting position. Pressure and duration measurements were acquired from the hypopharynx and upper esophageal sphincter (UES) using HRM. The UES residual pressure, UES relaxation duration, maximum preopening UES pressure, maximum postclosure UES pressure, maximum hypopharyngeal pressure, maximum hypopharyngeal pressure rise rate and hypopharyngeal pressure duration were analyzed across bolus volumes using repeated measures of one-way analysis of variance. A significant increase in UES residual pressure associated with increased bolus volume during water and paste swallowing was observed. Furthermore, UES relaxation duration was significantly increased with increasing in bolus volume for all three material swallows. No significant volume effects were found on the hypopharynx. In summary, bolus volume has a significant effect on the residual pressure and relaxation duration, but no effect on maximum preopening pressure or maximum postclosure pressure of the UES. Maximum hypopharyngeal pressure, maximum hypopharyngeal pressure rise rate and pressure duration were also not affected by bolus volume. Consideration of these variables is paramount in understanding normal and pathological swallowing.

Lin T ，Xu G ，Dou Z ，Lan Y ，Yu F ，Jiang L ... -  《-》

The effect of bolus consistency on swallowing function measured by high-resolution manometry in healthy volunteers.

This study evaluated the effects of three levels of bolus consistency (water, thick liquid, and paste) on the nature and duration of physiologic pressure while swallowing in healthy adults using high-resolution manometry (HRM). A case series of healthy adults. Thirty-four healthy young adults (mean age: 24.29 years) were instructed to swallow 3 mL and 10 mL of water, thick liquid, and paste material, respectively, during which the upper esophageal sphincter (UES) and pharyngeal pressures were measured by HRM. Variables that included maximum pharyngeal pressure, duration of pharyngeal pressure, pharyngeal pressure rise rate, UES residual pressure, duration of UES relaxation, and maximum preopening as well as postclosure UES pressure were analyzed across the three bolus consistencies by one-way repeated measures analysis of variance. Maximum pharyngeal pressure, duration of pharyngeal pressure, duration of UES relaxation, maximum preopening UES pressure, and maximum postclosure UES pressure were significantly increased while swallowing water when compared with the thick liquid and paste materials. No significant differences were observed in UES residual pressure and pharyngeal pressure rise rate among the three different consistencies. Variations in bolus consistency appear to have a significant effect on physiologic pressure and duration in healthy adults while swallowing water when compared with thicker materials. Identification of the differences across various bolus consistencies could provide further insight into the pathophysiology of both normal and pathological swallowing. 4. Laryngoscope, 127:173-178, 2017.

Lan Y ，Xu GQ ，Yu F ，Lin T ，Jiang LS ，Liu F ... -  《-》

Swallowing pressure and pressure profiles in young healthy adults.

To measure the swallowing pressure (SP) of normal subjects using a 2.64-mm-diameter high-resolution manometry (HRM) catheter with 36 circumferential sensors. Repeated measures with subjects serving as controls. Thirty healthy subjects swallowed water at different temperatures and volumes to examine the maximum SP at the velopharynx, meso-hypopharynx, upper esophageal sphincter (UES), and cervical esophagus, and the duration of lowered pressure at the UES. The maximum SP at any location was unaffected by the volume of water, whereas the maximum SP at the UES and cervical esophagus was affected by the temperature. The duration of lowered SP at the UES was significantly prolonged with 10 versus 2 mL of cold water. The pressure curve in males had two peaks (at the velopharynx and UES), whereas that of females had a single peak at the UES. Our data obtained with 2.64-mm HRM demonstrated that as the bolus volume is increased, the duration of lowered SP at the UES is prolonged. The higher maximum SP at the velopharynx in males versus females suggests that there may be a gender difference in pressure at the velopharynx that has not been described previously. This implies that it is necessary to take gender differences into consideration when evaluating the etiology of swallowing dysfunction by examining the SP and SP curve. Moreover, the thinner catheter is less invasive and may contribute to obtaining more physiological measurements.

Matsubara K ，Kumai Y ，Samejima Y ，Yumoto E ... -  《-》

Effect of three different chin-down maneuvers on swallowing pressure in healthy young adults.

To determine the effects of three different chin-down maneuvers on swallowing pressure (SP) in healthy young adults using high-resolution manometry (HRM). Repeated measures with subjects serving as their own controls. Twenty-six healthy subjects (average age 26.4 [range 21-35] years) swallowed 5 mL of cold water to examine the maximum swallowing pressure (MSP) at the velopharynx, meso-hypopharynx, and upper esophageal sphincter (UES), and to determine the duration of lowered SP at the UES using HRM. The subjects swallowed in the neutral position as a control and in the following three chin-down positions: 1) head flexion (HF); 2) neck flexion (NF); and 3) combined head and neck flexion (HFNF). The MSP at the velopharynx and meso-hypopharynx did not significantly differ among the three chin-down positions. Upon swallowing in the NF posture, the MSP was significantly lower (P < 0.0001) at the UES, and the duration of the lowered SP at the UES was significantly prolonged (P = 0.0010) compared to the neutral position. In comparison, the duration of lowered SP at the UES was significantly (P = 0.0001) shorter in the HF position than in the neutral position. Moreover, the HFNF position significantly (P = 0.0276) lowered the MSP at the UES compared to the control position. In young healthy adults, NF maneuver resulted in significantly lower MSP and longer duration of the lowered swallowing pressure at the UES, which might assist bolus passage through the UES. 3b.

Matsubara K ，Kumai Y ，Kamenosono Y ，Samejima Y ，Yumoto E ... -  《-》

Effects of age, gender, bolus condition, viscosity, and volume on pharyngeal and upper esophageal sphincter pressure and temporal measurements during swallowing.

Butler SG ，Stuart A ，Castell D ，Russell GB ，Koch K ，Kemp S ... -  《-》