High-resolution manometry of the pharynx and esophagus

Abstract

This chapter describes the use of high-resolution manometry (HRM) for the assessment of pharyngeal, upper esophageal sphincter, and esophageal function during deglutition. Based on color plot technology, pressure patterns in both the pharynx and the esophagus are described in health and swallow pathology. The analysis of these patterns is determined by specific metrics that describe the deglutitive motor function that can be driving bolus flow as seen on videofluoroscopy or detected by impedance. Esophageal motor function is worldwide classified using the Chicago classification. Although currently such a classification is not available yet for the pharynx and UES dysfunction, recently much progress has been made in deriving clinically relevant pharyngeal HRM metrics. HRM can, combined with videofluoroscopic or impedance assessment, identify the motor patterns driving the pathogenesis of different dysphagic phenotypes.