A new evaluation of the upper esophageal sphincter using the functional lumen imaging probe: a preliminary report.
AffiliationSchools of Clinical Medicine Clinical Speech and Language Studies, Trinity College Dublin Speech and Language Therapy Department Medical Physics and Clinical Engineering, Adelaide and Meath Hospital, Dublin, Ireland Department of Neurosciences, ExpORL, University of Leuven Neurogastroenterology and Motility Clinic, University Hospital Leuven, Leuven, Belgium.
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CitationA new evaluation of the upper esophageal sphincter using the functional lumen imaging probe: a preliminary report. 2012:notDis Esophagus
PublisherDiseases of the esophagus : official journal of the International Society for Diseases of the Esophagus / I.S.D.E
JournalDiseases of the esophagus : official journal of the International Society for Diseases of the Esophagus / I.S.D.E
AbstractObjective and reliable evaluation of upper esophageal sphincter (UES) opening during swallowing based on videofluoroscopy and pharyngeal manometry challenges dysphagia clinicians. The functional lumen imaging probe (FLIP) is a portable tool based on impedance planimetry originally designed to measure esophogastric junction compliance. It is hypothesized that FLIP can evaluate UES distensibility, and can provide UES diameter and pressure measurements at rest, during swallowing, and during voluntary maneuvers. Eleven healthy adult subjects consented to FLIP evaluation. The probe was inserted transorally, and the balloon was positioned across the UES. Two 20-mL ramp distensions were completed. Changes in UES diameter and intraballoon pressure were measured during dry and 5-mL liquid swallows, and during voluntary swallow postures and maneuvers employed in clinical practice. The protocol was completed by 10 of 11 healthy subjects. Mean intraballoon pressure increased throughout 5-mL (5.8 mmHg; -4.5-18.6 mmHg), 10-mL (8.7 mmHg; 2.3-28.5 mmHg), 15-mL (17.3 mmHg; 9.5-34.8 mmHg), and 20-mL (31.2 mmHg; 16-46.3 mmHg) balloon volumes. Mean resting UES diameter (4.9 mm) increased during dry swallows (9.2 mm) and 5-mL liquid swallows (7.7 mm). Mean UES diameter increased during 5-mL liquid swallows with head turn to right (8.1 mm) and left (8.3 mm), chin tuck (8.4 mm), effortful swallow (8.5 mm), Mendelsohn maneuver (8.1 mm), and supraglottic swallow (7.8 mm). FLIP was safely inserted and distended in the UES, and provided useful quantitative data regarding UES distensibility and UES diameter changes during swallowing maneuvers. Further research is being conducted to explore the role of FLIP in UES evaluation.
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