Manometry and Electromyography of the Pharyngeal Muscles in Patients With Dysphagia

Abstract

Simultaneous recording of the electromyographic activity of the pharyngeal muscles and the intraluminal pressure in the upper sphincter zone was performed routinely in patients with swallowing problems for the first time, to our knowledge. This technique was found to be very useful for the localization of the "site of lesion." The procedure is safe, easy to master, and causes minimal inconvenience. It can reveal, in the most direct way, whether the disturbance is in the hypopharyngeal musculature (represented by the inferior constrictor muscle), in the cricopharyngeal muscle (spasm or lack of relaxation), or in the synchronization between them. Simultaneous recording of intraluminal pressure adds valuable information about the mechanical events associated with electromyographic activity. It was found that in pathologic cases there is quite often no correlation between the electrical and mechanical events. Thus, simultaneous recording of both electrical and mechanical events is essential for the understanding of the pathophysiology of disturbances of deglutition.

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“…The interruption in EMG activity lasts 0.4-0.5 sec and is followed immediately by a transient increase in EMG activity and pressure as the peristaltic contraction wave passes from the pharynx through the UES to the cervical esophagus [ 1, 3,. At times a brief increase in EMG activity just before the cessation of activity has been recorded [18,21,22]. The speed of the peristaltic pressure wave at the level of the UES is on the order of 15 cm/sec [2,4].…”