Characterization of pharyngeal peristaltic pressure variability during volitional swallowing in healthy individuals

BackgroundRecent technological advances incorporated in high resolution manometry have justifiably heightened interest in manometric evaluation of the pharynx. Despite this interest, from both physiologic and clinical perspective there remain a number of unanswered questions regarding the magnitude of variability of pharyngeal pressure phenomena. Therefore, the aim of the present study was to characterize in healthy individuals the inter-subject and recording-site specific variability of pharyngeal peristaltic pressure phenomena. MethodsWe studied 32 healthy subjects (age: 21-83years,20 under 35years) during dry,5 and 10mL water swallows x3. Pharyngeal peristaltic pressures were recorded using a high resolution (HR) manometric system and a catheter assembly with 36 circumferential sensors spaced at 1cm intervals positioned trans-nasally to traverse the pharynx, UES and proximal esophagus. Key ResultsBoth site-specific pressure data and the Pharyngeal contractile integral (PhCI) showed wide dispersion ranging between values under 50mm Hg to over 300mm Hg and 100-600mm Hg/cm/s,respectively. There was also wide range of dispersion of data for both the standard deviations and the coefficient of variation for all sites (P=.001). The coefficient of variation for PhCI ranged between 0.02 and 0.25 representing data dispersion of 2-25 percent of the mean among subjects (P=.001). Position, age and volume of swallowed fluid did not influence the magnitude of variability. ConclusionsDeglutitive Pharyngeal peristalsis generates pressures with significant degree of site-related and inter-subject variability. This variability is not influenced by age, position and volume of swallowed fluid.