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Effect of Different Viscosities on Pharyngeal Pressure During Swallowing: A Study Using High-Resolution Manometry

  • Donghwi Park
    Affiliations
    Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea
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  • Cheol Min Shin
    Affiliations
    Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea
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  • Ju Seok Ryu
    Correspondence
    Corresponding author Ju Seok Ryu, MD, PhD, Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, South Korea.
    Affiliations
    Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea
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Published:August 11, 2016DOI:https://doi.org/10.1016/j.apmr.2016.07.013

      Abstract

      Objectives

      To investigate and compare the mechanism of swallowing with respect to the viscosity of ingested material between patients with and without dysphagia.

      Design

      Prospectively collected and retrospectively analyzed clinical study.

      Setting

      General teaching hospital, rehabilitation unit.

      Participants

      We retrospectively reviewed the high-resolution manometry (HRM) results of 35 patients with dysphagia symptoms (N=35). Additionally, we included 18 patients without dysphagia. Based on videofluoroscopic swallowing study results, we classified the patients into 2 groups: one with aspiration and the other without aspiration.

      Intervention

      Swallowing of a 5-mL thin liquid and 5-mL honey-like liquid in all patients.

      Main Outcome Measure

      HRM of various variables during the swallowing process.

      Results

      There was no significant difference between the thin liquid and honey-like liquid with respect to parameters for HRM in the patients without dysphagia and in the nonaspiration and aspiration groups. However, in a comparison between thin liquid and honey-like liquid with respect to visuospatial and timing variables, the degree of differences in the maximal pressure of the velopharynx in the aspiration group was significantly larger than the patients without dysphagia and the nonaspiration group (P<.05).

      Conclusions

      Our results indicate that there is a clear difference in the degree of adaptation to viscosity between the 3 groups—patients without dysphagia, patients with aspiration, and patients without aspiration. These differences may provide an explanation for the mechanism of swallowing, which may be useful for the treatment of dysphagia.

      Keywords

      List of abbreviations:

      HRM (high-resolution manometry), UES (upper esophageal sphincter), VFSS (videofluoroscopic swallowing study)
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