The areas of interest are from the velopharynx to the upper esophageal sphincter (UES). Once the catheter is positioned within the pharynx, participants rest for 5?10 minutes for adaptation prior to swallowing. Manometric catheter is lubricated with a 2% lidocaine jelly to ease the passage of the catheter through the pharynx. 4 A 10% lidocaine spray is applied through the nasal passage. Participants are instructed not to eat for 4 hours and not drink liquids for 2 hours prior to testing in order to avoid any potential confounding effects of satiety. The examination is performed at a neutral head and sitting position. In the present review, we will discuss the methods to use HRIM, including the interpretation of its parameters, to assist in the evaluation of pharyngeal dysphagia. The main reason may be that the test method and result interpretation are not easily applicable and standardized. 2 Although HRIM provides precise pharyngeal pressure information, it has yet to be applied to routine clinical practice as the assessment method for dysphagia. It also has improved sensitivity, reliability, and accuracy. HRIM has pressure sensors at 1?2 cm intervals and uses a solid catheter, which enables the evaluation at the sitting position. Recently, high-resolution impedance manometry (HRIM) was developed and used to evaluate pharyngeal dysphagia. There exists a correlation between the abnormalities in generating adequate pharyngeal pressure and developing pharyngeal dysphagia therefore new methods to evaluate and analyze the pharyngeal pressure events are required to reveal the underlying pathophysiology of dysphagia.Īs conventional manometry uses hydrostatic pressure, only the limited sensors and positions (supine) were allowed therefore, its application to pharyngeal dysphagia was nearly impossible. However, VFSS could only evaluate the movement of anatomic structures and bolus, and could not evaluate the generated pharyngeal pressure. Until now, a videofluoroscopic swallow study (VFSS), an X-ray-based analysis of swallowing, has been a gold standard in analyzing the swallowing function in patients with dysphagia. Pharyngeal swallow is a complex event that requires subsequent muscular contractions and pressure generation to move a bolus from the mouth to the esophagus. Dysphagia results from diverse etiologies, and its likelihood of occurrence increases with age. Keywords: Deglutition disorders, Diagnosis, Manometry, Pharynxĭysphagia means difficulty in swallowing, which may be followed by aspiration and inadequate nutrition. In the present review, we will review how to apply HRIM for the evaluation of pharyngeal dysphagia, including the interpretation of its parameters. With HRIM, the pressure and timing data could be obtained at a precise anatomical structure. The anatomical landmarks for HRIM parameters are velopharynx, tongue base, epiglottis, low pharynx, and upper esophageal sphincter. The main reasons are thought to be that the test method and result interpretation are not easily applicable and standardized. Although HRIM provides precise pharyngeal pressure information, it has yet to be used as part of routine clinical practice for the assessment of dysphagia. Recently, high-resolution impedance manometry (HRIM) was developed and used for the evaluation of pharyngeal dysphagia. The pharyngeal phase of swallowing is a complex event consisted with subsequent muscular contractions and pressure generation to move a bolus from the mouth to the esophagus.
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