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Updated: Jun 6, 2026

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Pharyngeal flow interval: a novel impedance-based parameter correlating with aspiration
L Noll1, N Rommel, G P Davidson
1Gastroenterology Unit, Child, Youth & Women's Health Service, North Adelaide, SA, Australia.
Insights
Pharyngeal impedance recording, using a novel flow interval parameter, can identify aspiration risk in children with cerebral palsy. This method shows promise for predicting swallowing difficulties.
Area of Science:
- Otolaryngology
- Swallowing Disorders
- Biomedical Engineering
Background:
- Pharyngeal impedance recording is an emerging technique for assessing swallowing function.
- Its utility in evaluating pharyngeal function, particularly in relation to bolus residue and aspiration, requires further establishment.
- This study investigates a novel parameter, impedance flow interval, and the impact of catheter configuration.
Purpose of the Study:
- To evaluate the impedance flow interval as a novel parameter for assessing pharyngeal function.
- To correlate impedance flow interval with post-swallow bolus residue and deglutitive aspiration.
- To assess the effect of different catheter configurations on impedance measurements.
Main Methods:
- 12 children (1.8-13.5 years) with cerebral palsy underwent simultaneous videofluoroscopy and pharyngeal impedance recording.
- Two catheter configurations (1.9mm diameter/1cm electrodes and 3.2mm diameter/2cm electrodes) were utilized.
- Impedance flow interval was calculated and correlated with fluoroscopic findings of residue and aspiration.
Main Results:
- A longer flow interval was significantly associated with aspiration across both catheter configurations.
- A longer flow interval was associated with bolus residue, particularly with the larger catheter (Catheter 2).
- Higher flow interval was a stronger predictor of aspiration (OR 13.4) than the presence of residue (OR 3.8).
Conclusions:
- Impedance measurement, specifically the flow interval, can detect alterations in pharyngeal swallow flow characteristics.
- This novel parameter shows potential for predicting deglutitive aspiration risk in pediatric patients.
- Pharyngeal impedance recording offers a promising, objective method for swallowing function assessment.
Background:
The role of pharyngeal impedance recording for assessing pharyngeal function is yet to be established. The aim of this study was to evaluate impedance flow interval, a novel parameter, in relation to bolus residue and the occurrence of aspiration. The effect of catheter configuration was also assessed.
Methods:
We studied 12 children (1.8-13.5years) with cerebral palsy, who were all referred for a videofluoroscopy due to suspected aspiration risk. Pharyngeal impedance patterns during bolus swallowing were recorded simultaneously with fluoroscopy. Two different catheter configurations were used: Catheter 1, 1.9mm diameter with 1cm electrodes and Catheter 2, 3.2mm diameter with 2cm electrodes. The flow interval was based on the objective assessment of impedance drop and recovery across multiple impedance segments and was correlated with fluoroscopic evidence of postswallow bolus residue and deglutitive aspiration.
Key Results:
One hundred and thirty two liquid swallows were evaluated. Patient swallows with aspiration compared to those without aspiration had a longer flow interval (Cath 1 P=0.005; Cath 2 P<0.001). Patient swallows with residue had a longer flow interval, however this was only significant for swallows recorded using Catheter 2 (P=0.004). Multiple logistic regressions showed that higher flow interval was a better marker of the presence of aspiration [odds ratio (OR) 13.4 (3.0, 59.2); P<0.001] than the presence of residue [OR 3.8 (1.4, 10.3); P=0.01].
Conclusions & Inferences:
We present novel findings suggesting that impedance measurement can detect alterations in flow characteristics of pharyngeal swallow that have the potential to predict to deglutitive aspiration risk.
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