Comparison of unidirectional and circumferential manometric measures within the pharyngoesophageal segment: an exploratory study

Hernandez, Esther Guiu; Gozdzikowska, Kristin; Jones, Richard D.; Huckabee, Maggie‐Lee

doi:10.1007/s00405-018-5019-z

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…With the introduction of circumferentially recording pressure sensors spaced at one‐centimeter intervals, the above‐mentioned technical shortcomings can be overcome, which presents the opportunity to systematically include the manometric evaluation of the UES in clinically performed manometry. Data in this regard are emerging 74–76 and the present study contributes to the fundamental information in this field.…”

Section: Discussionmentioning

confidence: 70%

Variables influencing manometric parameters of deglutitive and non‐deglutitive upper esophageal sphincter: A study of 89 asymptomatic participants

Edeani

Kern

Ulualp

et al. 2021

Neurogastroenterology Motil

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Background High‐resolution manometry overcomes limitations imposed by axial and radial asymmetry as well as swallow and respiration‐induced movement of the upper esophageal sphincter (UES), allowing for its reliable use in evaluation of dysphagic and reflux patients. The aim of this study was to determine normative values and their variability across position, sex, age, height, weight, BMI, and volume for clinically relevant deglutitive and non‐deglutitive UES parameters. Methods We studied 89 asymptomatic volunteers age 19–90 years, (45 female) during 3–10 repetitions of dry, 5 and 10 ml water swallows at 30‐s intervals using high‐resolution manometry. Key Results Upper esophageal sphincter high‐pressure zone was longer in men than women and in supine than upright position. UES basal contractile integral and mean basal pressure were higher in supine compared to upright; higher in men than women, inversely correlated with age, correlated positively with height and with weight in the supine position only. UES relaxation duration was longer in upright than in supine position but not affected by age, sex, height, weight, or BMI. It was longer with 5 and 10 ml compared with dry swallows. UES minimum/nadir relaxation and mean relaxation pressures were lower in upright than supine position, increased with increase in age and were higher in men than women. Conclusions and Inferences Position, sex, age, height, weight, and volume affect some deglutitive and non‐deglutitve UES manometric parameters. BMI does not affect the studied manometric parameters. These effects should be taken into consideration in clinical evaluation of UES.

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Section: Discussionmentioning

confidence: 70%

Variables influencing manometric parameters of deglutitive and non‐deglutitive upper esophageal sphincter: A study of 89 asymptomatic participants

Edeani

Kern

Ulualp

et al. 2021

Neurogastroenterology Motil

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“…The paradoxical appearance of P1 will need further investigation in order to either identify a physiological background or find an alternative explanation for its presence. A limitation of the measuring results by using a unidirectional manometric catheter cannot be completely excluded, although the high‐resolution, small‐diameter catheter used here is known to only minimally affect the dynamics of the UES 39,40 . Further limitations are certainly given due to the rather small study population size (n = 7), although experiments were performed repeatedly in each individual.…”

Section: Discussionmentioning

confidence: 97%

“…A limitation of the measuring results by using a unidirectional manometric catheter cannot be completely excluded, although the high-resolution, small-diameter catheter used here is known to only minimally affect the dynamics of the UES. 39,40 Further limitations are certainly given due to the rather small study population size (n = 7), although experiments were performed repeatedly in each individual. On the technical side, droplet formation stability in MIT-LAR should be enhanced as formation of satellite droplets was observed in this study.…”

Section: Limitationsmentioning

confidence: 99%

Upper Esophageal Sphincter Response to Laryngeal Adductor Reflex Elicitation in Humans

et al. 2020

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The laryngeal adductor reflex (LAR) is an important mechanism to secure the airways from potential foreign body aspiration. An involvement of the upper esophageal sphincter (UES) in terms of a laryngo-UES contractile reflex has been identified after laryngeal mucosa stimulation. However, the LAR-UES relationship has not yet been fully explained. This study aimed to determine the magnitude, latency, and occurrence rate of the UES pressure response when the LAR is triggered in order to elucidate the functional relationship between the larynx and the UES.Methods: This prospective study included seven healthy volunteers (5 female, 2 male, age 22-34 years). Laryngeal penetration was simulated by eliciting the LAR 20 times in each individual by applying water-based microdroplets onto the laryngeal mucosa. UES pressures were measured simultaneously using high-resolution manometry.Results: Two distinct pressure phases (P1, P2) associated with the LAR were identified. P1 corresponded with a shortterm UES pressure decrease in two subjects and a pressure increase in five subjects occurring 200 to 500 ms after the stimulus. In P2, all subjects experienced an increase in UES pressure with a latency time of approximately 800 to 1700 ms and an average of 40 to 90 mmHg above the UES resting tone.Conclusion: Foreign bodies penetrating the laryngeal inlet lead to a reflex contraction of the UES. Phase P1 could be a result of vocal fold activity caused by the LAR, leading to pressure changes in the UES. The constriction during P2 could strengthen the barrier function of the UES in preparation to a subsequent cough that may be triggered to clear the airways.

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“…In the esophageal tract, there is evidence of radial symmetry in pressure, and this assumption is no longer valid in correspondence of radially asymmetric structures (e.g., UES and LES): for this reason, it seems reasonable that a circumferential system records more accurate data [56]. Hernandez et al [58] investigated within-subjects differences between unidirectional and circumferential pressure measurements in the pharyngoesophageal segment during swallows: unidirectional data were collected using a standard LRM catheter on 10 healthy subjects. The resulting recorded pressures were compared with circumferentially integrated data collected on the same subjects with a HRM system.…”

Section: High-resolution Manometry (Hrm)mentioning

confidence: 99%

Endoluminal Procedures and Devices for Esophageal Tract Investigation: A Critical Review

Spreafico,

Chiurazzi,

Bagnoli

et al. 2023

Sensors

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Diseases of the esophageal tract represent a heterogeneous class of pathological conditions for which diagnostic paradigms continue to emerge. In the last few decades, innovative diagnostic devices have been developed, and several attempts have been made to advance and standardize diagnostic algorithms to be compliant with medical procedures. To the best of our knowledge, a comprehensive review of the procedures and available technologies to investigate the esophageal tract was missing in the literature. Therefore, the proposed review aims to provide a comprehensive analysis of available endoluminal technologies and procedures to investigate esophagus health conditions. The proposed systematic review was performed using PubMed, Scopus, and Web of Science databases. Studies have been divided into categories based on the type of evaluation and measurement that the investigated technology provides. In detail, three main categories have been identified, i.e., endoluminal technologies for the (i) morphological, (ii) bio-mechanical, and (iii) electro-chemical evaluation of the esophagus.

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Comparison of unidirectional and circumferential manometric measures within the pharyngoesophageal segment: an exploratory study

Cited by 6 publications

References 19 publications

Variables influencing manometric parameters of deglutitive and non‐deglutitive upper esophageal sphincter: A study of 89 asymptomatic participants

Variables influencing manometric parameters of deglutitive and non‐deglutitive upper esophageal sphincter: A study of 89 asymptomatic participants

Upper Esophageal Sphincter Response to Laryngeal Adductor Reflex Elicitation in Humans

Endoluminal Procedures and Devices for Esophageal Tract Investigation: A Critical Review

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