The Potential Benefits of Applying Recent Advances in Esophageal Motility Testing in Patients with Esophageal Atresia
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Date
2017-06-21
Authors
Rommel, Nathalie
Rayyan, Maissa
Schreerens, Charlotte
Omari, Taher
Journal Title
Journal ISSN
Volume Title
Publisher
Frontiers Media S.A.
Rights
Copyright: © 2017 Rommel, Rayyan, Scheerens and Omari.
Rights Holder
Rommel, Rayyan, Scheerens and Omari.
Abstract
Infants and children with esophageal atresia commonly present with swallowing dysfunction or dysphagia. Dysphagia can lead to a range of significant consequences such as aspiration pneumonia, malnutrition, dehydration, and food impaction. To improve oral intake, the clinical diagnosis of dysphagia in patients with esophageal atresia should focus on both the pharynx and the esophagus. To characterize the complex interactions of bolus flow and motor function between mouth, pharynx, and esophagus, a detailed understanding of normal and abnormal deglutition is required through the use of adequate and objective assessment techniques. As clinical symptoms do not correlate well with conventional assessment methods of motor function such as radiology or manometry but do correlate with bolus flow, the current state-of-the-art diagnosis involves high-resolution manometry combined with impedance measurements to characterize the interplay between esophageal motor function and bolus clearance. Using a novel pressure flow analysis (PFA) method as an integrated analysis method of manometric and impedance measurements, differentiation of patients with impaired esophago-gastric junction relaxation from patients with bolus outflow disorders is clinically relevant. In this, pressure flow matrix categorizing the quantitative PFA measures may be used to make rational therapeutic decisions in patients with esophageal atresia. Through more advanced diagnostics, improved understanding of pathophysiology may improve our patient care by directly targeting the failed biomechanics of both the pharynx and the esophagus.
Description
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Keywords
esophageal atresia, wallowing dysfunction, dysphagia, esophagus, pharynx, bolus flow
Citation
Rommel N, Rayyan M, Scheerens C and Omari T (2017) The Potential Benefits of Applying Recent Advances in Esophageal Motility Testing in Patients with Esophageal Atresia. Front. Pediatr. 5:137. doi: 10.3389/fped.2017.00137