High-Resolution Manometry Evaluation of Pressures at the Pharyngo-upper Esophageal Area in Patients with Oropharyngeal Dysphagia Due to Vagal Paralysis

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dc.citation.issue5
dc.citation.volume32
dc.contributor.authorPinna, Bruno Rezende [UNIFESP]
dc.contributor.authorHerbella, Fernando A. M. [UNIFESP]
dc.contributor.authorde Biase, Noemi [UNIFESP]
dc.contributor.authorVaiano, Thays C. G. [UNIFESP]
dc.contributor.authorPatti, Marco G.
dc.coverageNew York
dc.date.accessioned2020-08-04T13:40:07Z
dc.date.available2020-08-04T13:40:07Z
dc.date.issued2017
dc.description.abstractThe 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.en
dc.description.affiliationUniv Fed Sao Paulo, Escola Paulista Med, Dept Ear Nose & Throat, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Escola Paulista Med, Dept Surg, Rua Diogo de Faria 1087 Cj 301, BR-04037003 Sao Paulo, SP, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Escola Paulista Med, Speech Language Pathol & Audiol Dept, Sao Paulo, Brazil
dc.description.affiliationUniv N Carolina, Dept Surg, Chapel Hill, NC USA
dc.description.affiliationUnifespUniv Fed Sao Paulo, Escola Paulista Med, Dept Ear Nose & Throat, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Escola Paulista Med, Dept Surg, Rua Diogo de Faria 1087 Cj 301, BR-04037003 Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Escola Paulista Med, Speech Language Pathol & Audiol Dept, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent657-662
dc.identifierhttp://dx.doi.org/10.1007/s00455-017-9811-5
dc.identifier.citationDysphagia. New York, v. 32, n. 5, p. 657-662, 2017.
dc.identifier.doi10.1007/s00455-017-9811-5
dc.identifier.issn0179-051X
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/57309
dc.identifier.wosWOS:000411556100008
dc.language.isoeng
dc.publisherSpringer
dc.relation.ispartofDysphagia
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectUpper esophageal sphincteren
dc.subjectPharynxen
dc.subjectDysphagiaen
dc.subjectOropharyngeal dysphagiaen
dc.subjectHigh-resolution manometryen
dc.subjectDeglutitionen
dc.subjectDeglutition disordersen
dc.titleHigh-Resolution Manometry Evaluation of Pressures at the Pharyngo-upper Esophageal Area in Patients with Oropharyngeal Dysphagia Due to Vagal Paralysisen
dc.typeinfo:eu-repo/semantics/article
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