Safety and Tolerability of Pharyngeal High-Resolution Manometry.

Purpose: Pharyngeal high-resolution manometry is an emerging practice for diagnosis of swallowing disorders in the upper aerodigestive tract. Advancement of a catheter through the upper esophageal sphincter may introduce safety considerations. There are no published studies of catheter placement complications, side effects, or tolerability. This study examines patient-reported side effects and tolerability of pharyngeal high-resolution manometry.

Method: Data were collected prospectively from 133 adult patients who underwent pharyngeal high-resolution manometry for the 1st time. Patients rated tolerability specific to "nose" and "throat" using a visual analog scale for 4 procedure time points: catheter passage, during the procedure, catheter removal, and after the procedure. Complications during catheter passage and removal were recorded. A telephone call was placed to the patient within 6 days to survey side effects experienced after the procedure.

Results: The patient sample was composed of 91 males and 42 females with a mean age of 66 years (SD = 14.4). Tolerability scores for catheter passage showed no significant difference (p = .7288) in the nose versus throat. Tolerability for females was significantly less (p = .0144) than that for males. Participants with the shortest procedure duration showed greatest discomfort in the nose (p = .0592) and throat (p = .0286). Complications included gag response (14%), emesis (2%), and epistaxis (< 1%). Side effects included sore throat (16%), nose discomfort (16%), coughing (11 %), nosebleed (4%), and nausea/vomiting (4%).

Conclusions: High-resolution manometry appears to have high patient tolerability with low incidence of side effects. Rates of complications and side effects are similar to those reported for other transnasal procedures.