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- Title
Characterization of swallow modulation in response to bolus volume in healthy subjects accounting for catheter diameter.
- Authors
Ferris, Lara; Schar, Mistyka; McCall, Lisa; Doeltgen, Sebastian; Scholten, Ingrid; Rommel, Nathalie; Cock, Charles; Omari, Taher
- Abstract
<bold>Objectives/hypothesis: </bold>Characterization of the pharyngeal swallow response to volume challenges is important for swallowing function assessment. The diameter of the pressure-impedance recording catheter may influence these results. In this study, we captured key physiological swallow measures in response to bolus volume utilizing recordings acquired by two catheters of different diameter.<bold>Study Design: </bold>Ten healthy adults underwent repeat investigations with 8- and 10-Fr catheters. Liquid bolus swallows of volumes 2.5, 5, 10, 20, and 30 mL were recorded. Measures indicative of distension, contractility, and flow timing were assessed.<bold>Methods: </bold>Pressure-impedance recordings with pressure-flow analysis were used to capture key distension, contractility, and pressure-flow timing parameters.<bold>Results: </bold>Larger bolus volumes increased upper esophageal sphincter distension diameter (P < .001) and distension pressures within the hypopharynx and upper esophageal sphincter (P < .05). Bolus flow timing measures were longer, particularly latency of bolus propulsion ahead of the pharyngeal stripping wave (P < .001). Use of a larger-diameter catheter produced higher occlusive pressures, namely upper esophageal sphincter basal pressure (P < .005) and upper esophageal sphincter postdeglutitive pressure peak (P < .001).<bold>Conclusions: </bold>The bolus volume swallowed changed measurements indicative of distension pressure, luminal diameter, and pressure-flow timing; this is physiologically consistent with swallow modulation to accommodate larger, faster-flowing boluses. Additionally, catheter diameter predominantly affects lumen occlusive pressures. Appropriate physiological interpretation of the pressure-impedance recordings of pharyngeal swallowing requires consideration of the effects of volume and catheter diameter.<bold>Level Of Evidence: </bold>NA. Laryngoscope, 128:1328-1334, 2018.
- Subjects
PHARYNGEAL cancer; DEGLUTITION disorders; CATHETERS; BOLUS (Digestion); HEALTH of adults; PHARYNX physiology; DEGLUTITION; DRINKING (Physiology); ESOPHAGUS; BIOELECTRIC impedance; PHARYNX; FUNCTIONAL assessment; DESCRIPTIVE statistics
- Publication
Laryngoscope, 2018, Vol 128, Issue 6, p1328
- ISSN
0023-852X
- Publication type
journal article
- DOI
10.1002/lary.26820