High-Resolution Manometry Evaluation of Pressures at the Pharyngo-upper Esophageal Area in Patients with Oropharyngeal Dysphagia Due to Vagal Paralysis

Dysphagia
B R PinnaMarco G Patti

Abstract

The motility of the pharynx, upper esophageal sphincter (UES), and proximal esophagus in patients with oropharyngeal dysphagia is still not entirely understood. High-resolution manometry (HRM) was recently added to the armamentarium for the study of this area. This study aims to describe HRM findings in patients with vagal paralysis. Sixteen patients (mean age 54 years, 69% females) with oropharyngeal dysphagia due to unilateral vagal paralysis were prospectively studied. All patients underwent HRM. Motility of the UES and at the topography of the velopharynx and epiglottis were recorded. (1) UES relaxation is compromised in a minority of patients, (2) epiglottis pressure does not follow a specific pattern, (3) vellum is hypotonic in half of the patients, (4) dysphagia is related to a low pharyngeal pressure, not to a flow obstruction at the level of the UES, and (5) aspiration is related to low pressures at the level of the UES and epiglottis and higher pressures at the level of the vellum. Pharyngeal motility is significantly impaired in patients with oropharyngeal dysphagia and unilateral vagal paralysis. In half of the cases, UES resting pressure is preserved due to unilateral innervation and relaxation is normal in most pa...Continue Reading

References

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Citations

Sep 21, 2018·Current Opinion in Otolaryngology & Head and Neck Surgery·Taher Omari, Mistyka Schar
Feb 2, 2019·The Journal of Laryngology and Otology·O ErdurK Ozturk
Oct 29, 2020·The Laryngoscope·Frederik J MeisollMartin Ptok
Jan 15, 2020·Brazilian Journal of Otorhinolaryngology·Bruno Rezende PinnaNoemi de Biase
Sep 1, 2021·Langenbeck's Archives of Surgery·Pedro NortonMarco G Patti

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