Findings of Abnormal Videoflouroscopic Swallowing Study Identified by High-resolution Mamometry Parameters

Publication date: Available online 24 October 2015
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Donghwi Park, Yoongul Oh, Ju Seok Ryu
ObjectivesTo identify the parameters of high-resolution manometry (HRM) with a significant correlation to abnormal findings of videofluoroscopic swallowing study (VFSS)Participants40 patients with dysphagia symptomsDesignProspective studySettingHospital rehabilitation departmentInterventionParticipants were evaluated once using VFSS in neutral head position, and evaluated twice using HRM with 5cc of thin fluid.Main Outcome MeasuresHRM parameters included maximal pressure, area integral, rise time, duration of the velopharynx and tongue base, maximal pressure of pre-upper esophageal sphincter (UES), low pharynx, cricopharyngeus, minimal UES pressure, UES activity time, and nadir UES duration. HRM parameters were compared with the findings of VFSS. ROC analysis was performed to obtain the cutoff value, sensitivity, and specificity of HRM parameters for the prediction of findings of VFSS.ResultsThe maximum pressure of velopharynx showed a significantly positive prediction for most abnormal parameters of VFSS in the pharyngeal phase. Nadir UES pressure duration was significant for impaired laryngeal elevation, residue at pyriformis sinus, and combination of penetration and aspiration. The maximum pressure of velopharynx below 180.0 showed 100% sensitivity and 75.0% specificity for the presence of penetration and aspiration, and the cutoff point of 178.8 showed 86.7% sensitivity and 75.0% specificity for the presence of subglottic aspiration.ConclusionsThis study identified significant HRM parameters that are highly specific for individual abnormalities of VFSS , suggesting the cutoff value, sensitivity, and specificity. Since HRM could inform the quantitative measurement of pharyngeal weakness, the cutoff value for HRM parameters could be used to predict aspiration in patients with pharyngeal weakness.



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