Characterization of swallow modulation in response to bolus volume in healthy subjects accounting for catheter diameter

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Date
2017-08-31
Authors
Ferris, Lara
Schar, Mistyka
McCall, Lisa M
Doeltgen, Sebastian
Scholten, Ingrid Maria
Rommel, Nathalie
Cock, Charles
Omari, Taher
Journal Title
Journal ISSN
Volume Title
Publisher
Wiley
Rights
© 2017 John Wiley & Sons, Inc. All rights reserved.
Rights Holder
John Wiley & Sons, Inc.
Abstract
Objectives/Hypothesis Characterization of the pharyngeal swallow response to volume challenges is important for swallowing function assessment. The diameter of the pressure‐impedance recording catheter may influence these results. In this study, we captured key physiological swallow measures in response to bolus volume utilizing recordings acquired by two catheters of different diameter. Study Design Ten healthy adults underwent repeat investigations with 8‐ and 10‐Fr catheters. Liquid bolus swallows of volumes 2.5, 5, 10, 20, and 30 mL were recorded. Measures indicative of distension, contractility, and flow timing were assessed. Methods Pressure‐impedance recordings with pressure‐flow analysis were used to capture key distension, contractility, and pressure‐flow timing parameters. Results Larger bolus volumes increased upper esophageal sphincter distension diameter (P < .001) and distension pressures within the hypopharynx and upper esophageal sphincter (P < .05). Bolus flow timing measures were longer, particularly latency of bolus propulsion ahead of the pharyngeal stripping wave (P < .001). Use of a larger‐diameter catheter produced higher occlusive pressures, namely upper esophageal sphincter basal pressure (P < .005) and upper esophageal sphincter postdeglutitive pressure peak (P < .001). Conclusions The bolus volume swallowed changed measurements indicative of distension pressure, luminal diameter, and pressure‐flow timing; this is physiologically consistent with swallow modulation to accommodate larger, faster‐flowing boluses. Additionally, catheter diameter predominantly affects lumen occlusive pressures. Appropriate physiological interpretation of the pressure‐impedance recordings of pharyngeal swallowing requires consideration of the effects of volume and catheter diameter.
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This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving'. © 2017 John Wiley & Sons, Inc. All rights reserved. This author accepted manuscript is made available following 12 month embargo from date of publication (August 2017) in accordance with the publisher’s archiving policy
Keywords
pharyngeal swallow response, wallowing function assessment, bolus volume
Citation
Ferris, L., Schar, M., McCall, L., Doeltgen, S., Scholten, I., Rommel, N., … Omari, T. (2017). Characterization of swallow modulation in response to bolus volume in healthy subjects accounting for catheter diameter. The Laryngoscope. https://doi.org/10.1002/lary.26820