Article

OBJECTIVE: To identify the parameters of high-resolution manometry (HRM) with a
significant correlation to abnormal findings of videofluoroscopic swallowing
study (VFSS). DESIGN: Prospective study. SETTING: Hospital rehabilitation
department. PARTICIPANTS: Patients with dysphagia symptoms (N=40). INTERVENTION:
Participants were evaluated once using VFSS in neutral head position and
evaluated twice using HRM with 5mL of thin fluid. MAIN OUTCOME MEASURES: HRM
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.
Receiver operating characteristic analysis was performed to obtain the cutoff
value, sensitivity, and specificity of HRM parameters for the prediction of
findings of VFSS. RESULTS: The maximum pressure of the 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 the velopharynx <180.0 showed 100%
sensitivity and 75% specificity for the presence of penetration and aspiration,
and the cutoff point of 178.8 showed 86.7% sensitivity and 75% specificity for
the presence of subglottic aspiration. CONCLUSIONS: This study identified
significant HRM parameters that are highly specific for individual abnormalities
of VFSS, suggesting the cutoff value, sensitivity, and specificity. Because 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.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS