The upper esophageal sphincter in the high-resolution manometry era

Area of Science:

• Gastroenterology
• Swallowing Disorders
• Diagnostic Technology

Background:

• Upper esophageal sphincter (UES) evaluation was historically limited by conventional manometry.
• High-resolution manometry (HRM) has overcome these limitations, enabling detailed UES assessment.
• UES assessment was previously neglected in routine manometric testing.

Purpose of the Study:

• To review current knowledge on manometric UES evaluation in health and disease using HRM.
• To highlight the capabilities of HRM in assessing UES parameters.
• To explore the role of UES dysfunction in various medical conditions.

Main Methods:

• Systematic review of current literature on UES manometry in the HRM era.
• Analysis of parameters measured by HRM for UES evaluation.
• Correlation of UES manometric findings with specific diseases.

Main Results:

• HRM provides more precise UES measurements than conventional manometry.
• Key UES parameters include extension, basal pressure, residual pressure, and relaxation duration.
• UES dysfunction is observed in achalasia, GERD, globus, neurological diseases, and Zenker's diverticulum.

Conclusions:

• UES dysfunction is integral to several disease processes.
• HRM facilitates the study of the UES, proving its clinical value.
• Accurate UES evaluation with HRM aids in diagnosing and understanding related disorders.