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

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

Author Pinna, Bruno Rezende Autor UNIFESP Google Scholar
Herbella, Fernando A. M. Autor UNIFESP Google Scholar
de Biase, Noemi Autor UNIFESP Google Scholar
Vaiano, Thays C. G. Autor UNIFESP Google Scholar
Patti, Marco G. Google Scholar
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 patients. Dysphagia therapy in these patients must be directed toward improvement in the oropharyngeal motility not at the UES.
Keywords Upper esophageal sphincter
Pharynx
Dysphagia
Oropharyngeal dysphagia
High-resolution manometry
Deglutition
Deglutition disorders
xmlui.dri2xhtml.METS-1.0.item-coverage New York
Language English
Date 2017
Published in Dysphagia. New York, v. 32, n. 5, p. 657-662, 2017.
ISSN 0179-051X (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 657-662
Origin http://dx.doi.org/10.1007/s00455-017-9811-5
Access rights Closed access
Type Article
Web of Science ID WOS:000411556100008
URI https://repositorio.unifesp.br/handle/11600/57309

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