The Emerging Importance of High-Resolution Manometry in the Evaluation and Treatment of Deglutition in Infants, Children, and Adults: New Opportunities for Speech-Language Pathologists

Abstract

<jats:sec> <jats:title>Purpose</jats:title> <jats:p>Diagnostic precision and prolonged testing before, during, and after deglutition is lacking across the age spectrum. Conventional clinical evaluation and radiologic methods are widely used but are reliant on human perception, carrying the risk of subjectivity. High-resolution manometry (HRM) is an emerging clinical and research tool and has the capability to objectively measure the dynamics, kinetics, regulatory, and correlation aspects of deglutition.</jats:p> </jats:sec> <jats:sec> <jats:title>Method</jats:title> <jats:p>We review the basics of manometry and the methods, metrics, and applications of this technology across the age spectrum. The goal is to aid in the translation of HRM from research tool to clinical use by the speech-language pathologist in the development of better global plans to understand normal and abnormal deglutition.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>HRM is an easily adaptable precise diagnostic tool that can be used to examine deglutition phases and abnormalities across the age spectrum from neonates to nonagenarians and can be a valuable adjunct to specialty evaluation of persistent deglutition disorders.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>New opportunities will emerge upon further research for larger-scale translation once normative data and recognition of biomarkers of abnormality are ascertained.</jats:p> </jats:sec>

Mechanisms and management considerations of parent-chosen feeding approaches to infants with swallowing difficulties: an observational study

“…Additionally, standardization is still being developed for infants 10 , 11 , and evaluation is typically limited to observation of the oral cavity and upper aerodigestive tract as well as only those swallows as captured by the radiologist. High resolution manometry (HRM) is an emerging technology in infants that permits prolonged evaluation of swallowing function without radiation exposure 12 – 20 . HRM allows evaluation of swallowing function by examining dynamic and kinetic relationships between the airway (glottal closure and respiratory changes) and the entire foregut (pharynx, upper esophageal sphincter- UES, esophagus, lower esophageal sphincter- LES).…”

A retrospective study of patients presenting with speech and language therapy needs within multidisciplinary Long COVID services: A service evaluation describing and comparing two cohorts across two NHS Trusts

“…As in Bolton, many SLTs in the UK have limited access to the aforementioned instrumental assessment procedures which may in future assist in dysphagia diagnostic specificity and hypothesis generation of pathophysiology. For example, there is limited yet emerging evidence and provision for pharyngeal manometry (Davidson et al., 2020), and ultrasound (Allen et al., 2021). As such there is even less evidence for targeted treatment approaches.…”