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Combined videomanometric identification of abnormalities related to pharyngeal retention
R Olsson1, J Castell, B Johnston
1Department of Diagnostic Radiology, Malmö University Hospital, Lund University, Sweden.
Rationale And Objectives:
The authors determined the usefulness of performing videoradiography and pharyngeal solid-state manometry during barium swallow in dysphagic patients with pharyngeal retention.
Methods:
Results were retrospectively analyzed of simultaneous videoradiography and manometry examinations in 14 patients with retention of barium in the pharynx. Twelve age-matched patients without retention served as a control group.
Results:
Patients with retention regularly had less opening of the upper esophageal sphincter than patients without retention (7.6 vs 10.3 mm, respectively; P = .003). In patients with retention, the laryngeal elevation was lower (17.1 vs 23.8 mm, respectively; P = .001), and the resting pressure of the upper esophageal sphincter was significantly lower (42.4 vs 54.0 mm Hg, respectively; P = .04). The duration of upper esophageal sphincter relaxation was also shorter in patients with retention (374 vs 603 msec, respectively; P = .003). The peak pharyngeal contraction pressure was not significantly different.
Conclusion:
The constrictors play a minor role in the conveyance of the bolus through the pharynx. Pharyngeal shortening could be the most important mechanism in bolus transport.