Requirements for accurate manometric recording of pharyngeal and esophageal peristaltic pressure waves.

The frequency characteristics and wave form of peristaltic pressure complexes occurring in the pharynx and esophagus of normal subjects were studied. For each of five subjects, five peristaltic waves were selected for analysis from the proximal and distal pharynx as well as the proximal, middle, and distal esophagus. Thus, 25 peristaltic waves were analyzed from each of the five regions studied, giving a total of 125 in all. After digitization of the peristaltic waves, pressure values were entered into a computer algorithm that performed a Fourier transformation to determine frequency content and wave slope. The computer analysis revealed that a frequency response flat to 5 Hz was adequate to record 98% of esophageal peristaltic waves with 98% accuracy. In contrast, recording accuracy up to 48 Hz was needed for high-fidelity recording in the pharynx. Rates of pressure change were substantially greater for pharyngeal peristaltic pressure complexes compared with esophageal peristaltic complexes. The results suggest that appropriately designed infused-catheter systems can readily meet the requirements for accurate recording of peristaltic pressure waves in the esophagus but not in the pharynx. Consequently, different instrumentation, such as an intraluminal strain gauge probe, is needed for accurate manometric recording of pharyngeal peristalsis.