The Correlation Between Manometric and Videofluoroscopic Measurements of the Swallowing Function in Brainstem Stroke Patients With Dysphagia

Abstract

The objective of the current study was to examine the correlation between high-resolution manometric and videofluoroscopic measurements of the swallowing function. In such cases in which manometric analysis is not feasible, it would be ideal if information regarding pressure during swallowing could be inferred from a videofluoroscopic swallowing study (VFSS) evaluation alone. The swallowing function was examined using simultaneous VFSS and high-resolution manometry (HRM) in 24 brainstem stroke survivors with dysphagia. The pharyngeal constriction ratio (PCR) and upper esophageal sphincter (UES) maximum opening diameter were measured using VFSS digital analysis. The pharyngeal maximum pressure and UES residual pressure were measured using HRM. The correlation coefficients between the PCR and pharyngeal maximum pressure and between the UES maximum opening diameter and UES residual pressure were calculated. The Spearman analyses were used to calculate the correlation coefficients between manometric and fluoroscopic parameters. The increase in the pharyngeal maximum pressure wave amplitude was significantly correlated with a decrease in the PCR (r=-0.849, P<0.001). The increase in the UES opening diameter was significantly correlated with a decrease in the UES residual pressure (r=-0.705, P<0.001). High space-time correlations between the pressure and kinematics of swallowing-related structures were obtained using simultaneous manometric and videofluoroscopic measurements. Certain VFSS measures are significantly correlated with measures of pressure assessed using HRM. The measures may be used as indicators of possible pressure deficits of swallowing.