Monitoring of Pharyngeal and Upper Esophageal Sphincter Activity with an Arterial Dilation Balloon Catheter |
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Authors: | Mats Lindén MD Sture Högosta MSc Tomas Norlander MD PhD |
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Institution: | (1) Department of Ear, Nose and Throat Disease, Falun Hospital, Falun, Sweden;(2) Department of Ear, Nose and Throat Disease, Falun Hospital, SE-791 82 Falun, Sweden |
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Abstract: | In patients with dysphagia and radiologic signs of dysfunction of the upper esophageal sphincter (UES), manometry is helpful
in giving a better understanding of muscular activity during swallowing. Traditional manometric methods include use of perfusion
catheters or solid-state intraluminal strain gauges. The rapid and asymmetric pressure variations in the UES and difficulties
compensating for the pharyngolaryngeal elevation during swallowing limit the value of these methods. We used an arterial balloon
dilation catheter as a probe in manometric recording of the UES in 28 healthy volunteers. Simultaneous perfusion manometry
of the pharynx with the same catheter was performed to assess the coordination of the muscular activity in the esophageal
entrance during swallowing. The catheter was well tolerated by all subjects. We found an average resting pressure in the UES
of 31.0 mmHg, and the average maximum pressure during contraction was 89.0 mmHg. The average duration of the swallowing act
was 3.9 s. All subjects displayed a complete UES relaxation and a normal coordination of propagated pressure in the hypopharynx
and UES. The results were highly reproducible and the interindividual range was low. Arterial dilation catheters are safe
and have suitable physical properties for pressure monitoring in the UES. |
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Keywords: | Upper esophageal sphincter Balloon dilation catheter Manometry Deglutition Deglutition disorders |
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