Defining Pharyngeal and Upper Esophageal Sphincter Disorders on High-Resolution Manometry-Impedance: The Leuven...

Area of Science:

• Gastroenterology and Swallowing Physiology
• Diagnostic Criteria Development
• Medical Consensus Initiatives

Background:

• Pharyngeal and upper esophageal sphincter (UES) motor disorders present diagnostic challenges.
• Existing diagnostic methods lack standardization for these conditions.
• Pharyngeal high-resolution manometry-impedance (P-HRM-I) offers advanced insights into swallowing function.

Purpose of the Study:

• To develop a standardized classification scheme for pharyngeal and UES motor disorders.
• To establish diagnostic criteria for UES dysfunction and pharyngeal contractile dysfunction.
• To leverage P-HRM-I metrics for improved diagnostic accuracy.

Main Methods:

• A formal deliberative Delphi process involving 26 multidisciplinary experts.
• Development of guidance for swallow assessment protocols.
• Establishment of diagnostic criteria based on P-HRM-I data.

Main Results:

• A stepwise evaluation method for UES dysfunction, assessing relaxation and opening under varying bolus conditions.
• Criteria for classifying pharyngeal contractile dysfunction as hypocontractility or hypercontractility.
• Defined metrics for UES and intrabolus pressures.

Conclusions:

• The Leuven Consensus provides a standardized nomenclature and criteria for P-HRM-I assessment.
• These recommendations aid in the diagnosis of oropharyngeal dysphagia.
• The consensus complements routine instrumental investigations for swallowing disorders.