High-resolution manometry of pharyngeal swallowing dynamics

Abstract

To transport abolus from the mouth into the stomach, regular contraction of the pharyngeal muscles and a coordinated function of the upper esophageal sphincter (UES) are necessary. The muscle contraction generates intraluminal pressure, which pushes the bolus continuously forward. In contrast to imaging studies, manometric methods enable assessment of intraluminal pressure buildup and the function of the muscles involved. These methods were initially established for the esophagus and have been used increasingly in the pharynx for 7-8years. Pharyngeal high-resolution manometry (pHRM) allows pressure measurements in high spatial and temporal resolution, and assessment of pharyngeal swallowing dynamics. An overview is given of the implementation, evaluation, and interpretation of the pHRM data, as well as of the current state of research. PubMed and Scopus were searched for the keywords "high-resolution manometry" and "pharynx" or "upper esophageal sphincter". Original articles, reviews, and book chapters on the subject pHRM were included. Swallowing pressure conditions in the pharynx and the UES can be assessed by pHRM. The spatiotemporal pressure plot gives an overview of changes in pharyngeal motor function. Determination of swallowing parameters enables asophisticated evaluation of swallowing; acomparison with normal values permits delimitation of pathologies. Although several swallowing parameters still need to be further evaluated for clinical routine, apHRM study should nowadays always be carried out for acomprehensive evaluation of the swallowing process.