Lara Ferris1, Nathalie Rommel2, Sebastian Doeltgen3, Ingrid Scholten3, Stamatiki Kritas4, Rammy Abu-Assi4, Lisa McCall4, Grace Seiboth4, Katie Lowe4, David Moore4, Jenny Faulks5, Taher Omari6. 1. Department of Gastroenterology, Women's and Children's Hospital, Adelaide, Australia; School of Medicine, Flinders University, Adelaide, Australia. Electronic address: lara.ferris@sa.gov.au. 2. Department of Neurosciences, ExpORL, Deglutology, KU Leuven, Leuven, Belgium. 3. School of Health Sciences, Speech Pathology & Audiology, Flinders University, Adelaide, Australia. 4. Department of Gastroenterology, Women's and Children's Hospital, Adelaide, Australia. 5. Department of Speech Pathology, Women's and Children's Hospital, Adelaide, Australia. 6. School of Medicine, Flinders University, Adelaide, Australia.
Abstract
OBJECTIVES: To determine which objective pressure-impedance measures of pharyngeal swallowing function correlated with clinically assessed severity of oropharyngeal dysphagia (OPD) symptoms. STUDY DESIGN: Forty-five children with OPD and 34 control children without OPD were recruited and up to 5 liquid bolus swallows were recorded with a solid-state high-resolution manometry with impedance catheter. Individual measures of pharyngeal and upper esophageal sphincter (UES) function and a swallow risk index composite score were derived for each swallow, and averaged data for patients with OPD were compared with those of control children without OPD. Clinical severity of OPD symptoms and oral feeding competency was based on the validated Dysphagia Disorders Survey and Functional Oral Intake Scale. RESULTS: Those objective measures that were markers of UES relaxation, UES opening, and pharyngeal flow resistance differentiated patients with and without OPD symptoms. Patients demonstrating abnormally high pharyngeal intrabolus pressures and high UES resistance, markers of outflow obstruction, were most likely to have signs and symptoms of overt Dysphagia Disorders Survey (OR 9.24, P = .05, and 9.7, P = .016, respectively). CONCLUSION: Pharyngeal motor patterns can be recorded in children by the use of HRIM and pharyngeal function can be defined objectively with the use of pressure-impedance measures. Objective measurements suggest that pharyngeal dysfunction is common in children with clinical signs of OPD. A key finding of this study was evidence of markers of restricted UES opening.
OBJECTIVES: To determine which objective pressure-impedance measures of pharyngeal swallowing function correlated with clinically assessed severity of oropharyngeal dysphagia (OPD) symptoms. STUDY DESIGN: Forty-five children with OPD and 34 control children without OPD were recruited and up to 5 liquid bolus swallows were recorded with a solid-state high-resolution manometry with impedance catheter. Individual measures of pharyngeal and upper esophageal sphincter (UES) function and a swallow risk index composite score were derived for each swallow, and averaged data for patients with OPD were compared with those of control children without OPD. Clinical severity of OPD symptoms and oral feeding competency was based on the validated Dysphagia Disorders Survey and Functional Oral Intake Scale. RESULTS: Those objective measures that were markers of UES relaxation, UES opening, and pharyngeal flow resistance differentiated patients with and without OPD symptoms. Patients demonstrating abnormally high pharyngeal intrabolus pressures and high UES resistance, markers of outflow obstruction, were most likely to have signs and symptoms of overt Dysphagia Disorders Survey (OR 9.24, P = .05, and 9.7, P = .016, respectively). CONCLUSION: Pharyngeal motor patterns can be recorded in children by the use of HRIM and pharyngeal function can be defined objectively with the use of pressure-impedance measures. Objective measurements suggest that pharyngeal dysfunction is common in children with clinical signs of OPD. A key finding of this study was evidence of markers of restricted UES opening.
Authors: Nicole M Rogus-Pulia; Corinne A Jones; Angela L Forgues; Jason Orne; Cameron L Macdonald; Nadine P Connor; Timothy M McCulloch Journal: Am J Speech Lang Pathol Date: 2020-06-23 Impact factor: 2.408
Authors: Corinne A Jones; Nicole M Rogus-Pulia; Angela L Forgues; Jason Orne; Cameron L Macdonald; Nadine P Connor; Timothy M McCulloch Journal: Dysphagia Date: 2018-10-31 Impact factor: 3.438