Navegando por Palavras-chave "Upper esophageal sphincter"

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    Anatomophysiology of the Pharyngo-Upper Esophageal Area in Light of High-Resolution Manometry
    (Springer, 2013-12-01) Silva, Luciana C. [UNIFESP]; Herbella, Fernando A. M. [UNIFESP]; Neves, Luciano R. [UNIFESP]; Vicentine, Fernando P. P. [UNIFESP]; Neto, Sebastiao P. [UNIFESP]; Patti, Marco G.; Universidade Federal de São Paulo (UNIFESP); Univ Chicago
    The motility of the pharynx, upper esophageal sphincter (UES), and proximal esophagus is still poorly understood. These structures have anatomical and functional peculiarities that hinder the accurate study of their motility with the technology traditionally available. High-resolution manometry (HRM) has characteristics that make it more suitable for the study of the upper digestive tract. This study aims to evaluate in healthy volunteers, using HRM and transnasal pharyngoscopy, (1) the correlation between anatomical landmarks and HRM plots and (2) the normal values for manometric parameters of the pharynx, UES, and proximal esophagus.We studied 40 asymptomatic volunteers with HRM (50 % male; median age, 27 years). Fourteen of those also underwent transnasal pharyngoscopy.Pharyngeal peak pressure, rise time, recovery time, and duration of contraction were 128 mmHg (range, 100-164 mmHg), 197 ms (range, 169-268 ms), 385 ms (range, 285-465 ms), and 604 ms (range, 544-626 ms) at the velum and 116 mmHg (range, 97-139 mmHg), 128 ms (range, 100-156 ms), 194 ms (range, 148-219 ms), and 336 ms (range, 267-386 ms) at the epiglottis, respectively. UES extension, basal pressure, residual pressure, and duration of relaxation were 3 cm (range, 2.6-3.6 cm), 76 mmHg (range, 58-109 mmHg), 4.4 mmHg (range, 1.2-6.9 mmHg), and 678 ms (range, 636-757 ms), respectively. in the proximal esophagus, wave amplitudes at 2, 4, and 6 cm below the UES were 72 mmHg (range, 53-97 mmHg), 56 mmHg (range, 42-76 mmHg), and 48 mmHg (range, 35-59 mmHg), respectively.In conclusion, normal values were established. These values may prove clinically useful and could contribute to future studies with dysphagic patients.
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    Avaliação da motilidade faríngea pela manometria de alta resolução em pacientes submetidos a tireoplastia tipo I
    (Universidade Federal de São Paulo (UNIFESP), 2018-10-25) Pinna, Bruno de Rezende [UNIFESP]; Biase, Noemi Grigoletto de [UNIFESP]; Fernandes, Fernando Augusto Mardiros Herbella [UNIFESP]; http://lattes.cnpq.br/4035568020554599; http://lattes.cnpq.br/3156326658988323; http://lattes.cnpq.br/9966897407737956; Universidade Federal de São Paulo (UNIFESP)
    Objectives: This study aims to compare the motility of the pharynx and UES in patients with UVFI before and after thyroplasty type I. Methods: We prospectively studied 15 patients with UVFI that underwent thyroplasty type I. Subjects were divided according to the topography of vagal injury and presence of dysphagia. High resolution manometry (HRM) was performed before and 30 days after surgery. Time and pressure manometric parameters at the topography of the velopharynx, epiglottis and UES were recorded. Results: Dysphagia was present in 67% of patients. 73% had lower vagal injuries. Manometric parameters did not change after thyroplasty for the whole population. The group of dysphagic patients; however, had an increase in residual pressure at the UES after thyroplasty (1.2 vs. 5.2 mmHg - p=0.05). Patients with low vagal injury developed higher peak pressure (100 vs. 108.9 mmHg - p=<0.001); lower rise time (347 vs. 330 ms - p=0.04); and higher up stroke (260 vs. 266.2 mmHg/ms p= 0.04) at the topography of the velopharynx after thyroplasty. Conclusion: Pharyngeal motility is affected by thyroplasty type I in patients with dysphagia and low vagal injury.
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    High-Resolution Manometry Evaluation of Pressures at the Pharyngo-upper Esophageal Area in Patients with Oropharyngeal Dysphagia Due to Vagal Paralysis
    (Springer, 2017) Pinna, Bruno Rezende [UNIFESP]; Herbella, Fernando A. M. [UNIFESP]; de Biase, Noemi [UNIFESP]; Vaiano, Thays C. G. [UNIFESP]; Patti, Marco G.
    The motility of the pharynx, upper esophageal sphincter (UES), and proximal esophagus in patients with oropharyngeal dysphagia is still not entirely understood. High-resolution manometry (HRM) was recently added to the armamentarium for the study of this area. This study aims to describe HRM findings in patients with vagal paralysis. Sixteen patients (mean age 54 years, 69% females) with oropharyngeal dysphagia due to unilateral vagal paralysis were prospectively studied. All patients underwent HRM. Motility of the UES and at the topography of the velopharynx and epiglottis were recorded. (1) UES relaxation is compromised in a minority of patients, (2) epiglottis pressure does not follow a specific pattern, (3) vellum is hypotonic in half of the patients, (4) dysphagia is related to a low pharyngeal pressure, not to a flow obstruction at the level of the UES, and (5) aspiration is related to low pressures at the level of the UES and epiglottis and higher pressures at the level of the vellum. Pharyngeal motility is significantly impaired in patients with oropharyngeal dysphagia and unilateral vagal paralysis. In half of the cases, UES resting pressure is preserved due to unilateral innervation and relaxation is normal in most patients. Dysphagia therapy in these patients must be directed toward improvement in the oropharyngeal motility not at the UES.