Investigation of pharyngeal swallowing function using high-resolution manometry.

OBJECTIVES/HYPOTHESIS: This study aimed to demonstrate the feasibility of a novel high-resolution manometry system, and to establish normal values of swallowing pressures along the velopharynx and upper esophagus.

STUDY DESIGN: Prospective study.

METHODS: Thirty-three asymptomatic adult Japanese controls were studied. A solid-state high-resolution manometry assembly with 36 circumferential sensors spaced 1 cm apart was positioned to record pressures during swallowing from the velopharynx to the upper esophagus. The maximum values of the swallowing (dry and 5 mL of water) pressures at velopharynx, meso-hypopharynx, and at the upper esophageal sphincter (UES) were measured. The resting UES pressure, the length of the part in the cervical esophagus showing the resting UES pressure, and the distances from the nostril to the above-mentioned points of pressure measurement were also measured.

RESULTS: The maximum value of dry and water swallowing pressures at the velopharynx, meso-hypopharynx and UES, and the distances from the nasal vestibulum to each point in men were 141.1 +/- 73.5 (mm Hg, mean +/- standard deviation) and 162.7 +/- 94.9, 175.3 +/- 59.7 and 182.9 +/- 83.6, 172.7 +/- 73.8 and 236.1 +/- 78.9, and 10.0 +/- 1.3 (cm) and 10.1 +/- 1.4, 14.1 +/- 1.5 and 14.4 +/- 1.3, 17.9 +/- 1.7 and 18.0 +/- 1.4, respectively. Those in women were 118.9 +/- 38.0 (mm Hg) and 124.7 +/- 43.4, 165.9 +/- 41.5 and 167.3 +/- 65.0, 149.2 +/- 68.7 and 243.7 +/- 87.4, and 9.5 +/- 1.2 (cm) and 9.4 +/- 1.2, 13.0 +/- 1.5 and 12.8 +/- 1.4, 15.8 +/- 1.5 and 16.0 +/- 1.3, respectively. The maximum value of resting UES pressure, the length of the part in the cervical esophagus showing the resting UES pressure and the distance from the nostril to the mid-point of the width of the resting UES pressure in men and in women were 70.2 +/- 30.0 mm Hg, 4.0 +/- 0.7 cm, 19.1 +/- 1.3 cm, and 61.8 +/- 26.7 mm Hg, 3.6 +/- 0.6 cm, 17.0 +/- 1.2 cm, respectively.

CONCLUSION: The present study provides anatomical and physiological information about normal swallowing along the velopharynx and upper esophagus, which will be an aid to the future clinical and investigative studies.