Evaluation of swallowing pressure in a patient with amyotrophic lateral sclerosis before and after cricopharyngeal myotomy using high-resolution manometry system

Takasaki, Kenji; Umeki, Hiroshi; Enatsu, Kaori; Kumagami, Hidetaka; Takahashi, Haruo

doi:10.1016/j.anl.2010.02.003

Cited by 24 publications

(22 citation statements)

References 16 publications

(17 reference statements)

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“…For example, hyolaryngeal excursion is often reported as “reduced” (e.g., [33,45,60]), however, when measured in reference to a scalar or anatomical marker, the results are more variable (e.g., [51,65]). Quantification of swallowing physiology has largely been limited to studies using manometry (e.g., [40,59,66]) and EMG (e.g., [67,68]). Manometry studies have yielded measures of reduced pharyngeal pressure during swallowing, and variable cricopharyngeal tonicity [16,41,45,40,69–71].…”

Section: Discussionmentioning

confidence: 99%

Trends in Research Literature Describing Dysphagia in Motor Neuron Diseases (MND): A Scoping Review

et al. 2017

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Dysphagia in motor neuron diseases (MNDs) is highly complex, affecting all stages of swallowing and leading to impaired swallowing safety and efficiency. In order to explore the degree to which research is capturing the symptom of dysphagia in MND, we conducted a scoping review of the existing literature. The primary aims of this review were to identify common themes within the literature on dysphagia in MND, explore patterns and trends in research focus, and identify if any imbalances exist between the research themes related to dysphagia description and management. Methods A comprehensive search strategy yielded 1690 unique articles for review. Following relevance screening, a total of 157 articles were included in the synthesis. Relevant data and keywords were extracted from each article and grouped into themes. Frequency estimates were calculated for each theme to identify trends across research literature. Results Swallowing impairment in MNDs is described in a variety of ways across current research. The most commonly reported theme was Aspiration/Penetration, mentioned in 73.2% of all included articles; a significant imbalance was identified between reports of swallowing safety and efficiency (p=0.008). The most frequently reported theme related to dysphagia management was Enteral Nutrition, and very few studies have reported on the efficacy of Rehabilitation/Compensatory recommendations. Conclusions It is suggested that researchers and clinicians remain mindful of imbalances and gaps in research, and aim to characterize dysphagia in MNDs in a comprehensive manner. Further research investigating discrete, measureable changes in swallowing pathophysiology would be beneficial to delineate the key factors contributing to impaired swallowing safety and efficiency.

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Section: Discussionmentioning

confidence: 99%

Trends in Research Literature Describing Dysphagia in Motor Neuron Diseases (MND): A Scoping Review

et al. 2017

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“…Pharyngeal high‐resolution manometry (HRM) is an emerging technique used to measure pharyngeal pressure during the swallow . Studies have shown that HRM is able to discern between normal and abnormal swallowing, and can also document change in pressure with different bolus sizes, swallow maneuvers, or surgical management . Differences in pharyngeal swallow pressure before and after an intervention may help to define the nature of the dysphagia, and to understand the efficacy of the intervention.…”

Section: Introductionmentioning

confidence: 99%

High‐resolution manometry and swallow outcomes after vocal fold injection medialization for unilateral vocal fold paralysis/paresis

et al. 2019

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Background: Injection medialization is performed to improve glottic closure, thereby airway protection. Overall objective to determine if unilateral injection medialization changes glottal area with concomitant adjustments in penetration/aspiration scale (PAS) scores and pharyngeal high-resolution manometry (HRM) parameters. Methods: Enrolled 17 adults with unilateral vocal fold paralysis/paresis and aspiration/penetration. Fiberoptic endoscopic evaluation of swallowing and pharyngeal HRM completed at (1) baseline (within 1 week before injection), (2) postinjection (within 1 week post injection), and (3) 1-month postinjection. Comparisons between time points for PAS scores, glottal area, pharyngeal pressure, and timing. Results: No significant differences in normalized glottal area. No significant differences in PAS scores, for any consistency. Significantly increased rate of mesopharynx pressure rise and maximum pressure at 1 month postinjection (P = .01 and .02, respectively) compared to baseline. Significant decrease in mesopharynx integral from baseline to 1 week postoperative (P = .03). Conclusion: Findings suggest unilateral vocal fold injection medialization had limited effect on swallow function. K E Y W O R D S dysphagia, medialization, pharyngeal high-resolution manometry, vocal fold paralysis

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“…In its brief research history, pharyngeal HRM has been shown to distinguish between normal and disordered swallowing (Geng, Hoffman, Jones, McCulloch, & Jiang, 2013; Mielens, Hoffman, Ciucci, McCulloch, & Jiang, 2012), quantify changes in pressure due to bolus size (Hoffman, Ciucci, Mielens, Jiang, & McCulloch, 2010) or maneuvers (Hoffman et al, 2012; McCulloch, Hoffman, & Ciucci, 2010; Takasaki, Umeki, Hara, Kumagami, & Takahashi, 2011; Takasaki, Umeki, Kumagami, & Takahashi, 2010; Umeki et al, 2009), and serve as an outcome measure following surgical management of dysphagia (Takasaki, Umeki, Enatsu, Kumagami, & Takahashi, 2010). The American Speech-Language-Hearing Association recognizes pharyngeal manometry as an appropriate instrumental assessment of swallowing ((ASHA), 2000, 2004) and has identified it as an emerging area of clinical practice for speech-language pathologists ((ASHA), 2008).…”

Section: Introductionmentioning

confidence: 99%

Reliability of an Automated High-Resolution Manometry Analysis Program Across Expert Users, Novice Users, and Speech-Language Pathologists

Jones

Hoffman

Geng

et al. 2014

J Speech Lang Hear Res

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Purpose The purpose of this study was to investigate inter- and intra-rater reliability among expert users, novice users, and speech-language pathologists with a semi-automated high-resolution manometry analysis program. We hypothesized that all users would have high intra-rater reliability and high inter-rater reliability. Method Three expert users, 15 novice users, and 5 speech-language pathologists participated in this study. Following a 20-minute training session, users analyzed 30 high-resolution manometry plots using an automated analysis program. Output parameters included two- and three-dimensional pressure integrals over 5 anatomical regions of interest. Intraclass correlations were used to examine inter- and intra-rater reliability. Analysis of variance was also performed to determine any differences in mean output parameter values. Results Within-group inter-rater reliability ranged from 0.54-0.99 and inter-group reliability ranged from 0.92-0.99. Intra-rater reliability ranged from 0.67-1.00 across all groups. There were no significant differences of output parameters between groups. Conclusion The high reliability observed after a short training session demonstrate that individuals with little to no prior knowledge of swallowing physiology can perform at a similar level as those with expertise. Given the quickness and ease of training in the use of this program, it has the potential for research and clinical utility.

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Evaluation of swallowing pressure in a patient with amyotrophic lateral sclerosis before and after cricopharyngeal myotomy using high-resolution manometry system

Cited by 24 publications

References 16 publications

Trends in Research Literature Describing Dysphagia in Motor Neuron Diseases (MND): A Scoping Review

Trends in Research Literature Describing Dysphagia in Motor Neuron Diseases (MND): A Scoping Review

High‐resolution manometry and swallow outcomes after vocal fold injection medialization for unilateral vocal fold paralysis/paresis

Reliability of an Automated High-Resolution Manometry Analysis Program Across Expert Users, Novice Users, and Speech-Language Pathologists

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