High-Resolution Pharyngeal Manometry and Impedance: Protocols and Metrics-Recommendations of a High-Resolution Pharyngeal Manometry International Working Group
High-Resolution Pharyngeal Manometry and Impedance: Protocols and Metrics-Recommendations of a High-Resolution Pharyngeal Manometry International Working Group
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DOI：
10.1007/s00455-019-10023-y
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发表时间：
2020-04-01
期刊：
影响因子：
2.6
通讯作者：
O'Rourke, Ashli
中科院分区：
文献类型：
--
作者：
Omari, Taher, I;Ciucci, Michelle;O'Rourke, Ashli
高分辨率测压传统上用于胃肠病学诊断临床和研究应用。最近，它在言语病理学和喉科实践中也发现了新的重要应用。高分辨率咽部测压国际工作组的成立是为了就高分辨率咽部测压 (HRPM) 的方法、协议和结果指标达成共识，并考虑将阻抗作为辅助方式。工作组承担了三项任务（1）调查专家目前在临床和/或研究实践中正在做什么； (2) 对支持特定 HRPM 指标对于理解吞咽生理学和病理生理学价值的文献进行回顾； (3) 通过德尔菲共识流程建立 HRPM 指标的核心成果集。专家调查结果用于创建推荐的 HRPM 方案，解决系统配置、导管插入和推注给药问题。最终文献综述中纳入了 92 篇文章，将 22 个 HRPM 阻抗指标分为三类：咽腔闭塞压力、下咽内推注压力和食管上括约肌 (UES) 功能。 8 个 HRPM-阻抗指标达成了稳定的 Delphi 共识：咽部收缩积分 (CI)、腭咽部 CI、下咽部 CI、最低点阻抗下咽部压力、UES 积分松弛压力、松弛时间和最大导纳。虽然仍然存在一些重要的未解答问题，但我们的工作代表了高分辨率咽部测压采集、测量和报告标准化的第一步。这可能为未来专门针对咽部吞咽障碍的基于 HRPM 的分类系统的建议提供信息。
High-resolution manometry has traditionally been utilized in gastroenterology diagnostic clinical and research applications. Recently, it is also finding new and important applications in speech pathology and laryngology practices. A High-Resolution Pharyngeal Manometry International Working Group was formed as a grass roots effort to establish a consensus on methodology, protocol, and outcome metrics for high-resolution pharyngeal manometry (HRPM) with consideration of impedance as an adjunct modality. The Working Group undertook three tasks (1) survey what experts were currently doing in their clinical and/or research practice; (2) perform a review of the literature underpinning the value of particular HRPM metrics for understanding swallowing physiology and pathophysiology; and (3) establish a core outcomes set of HRPM metrics via a Delphi consensus process. Expert survey results were used to create a recommended HRPM protocol addressing system configuration, catheter insertion, and bolus administration. Ninety two articles were included in the final literature review resulting in categorization of 22 HRPM-impedance metrics into three classes: pharyngeal lumen occlusive pressures, hypopharyngeal intrabolus pressures, and upper esophageal sphincter (UES) function. A stable Delphi consensus was achieved for 8 HRPM-Impedance metrics: pharyngeal contractile integral (CI), velopharyngeal CI, hypopharyngeal CI, hypopharyngeal pressure at nadir impedance, UES integrated relaxation pressure, relaxation time, and maximum admittance. While some important unanswered questions remain, our work represents the first step in standardization of high-resolution pharyngeal manometry acquisition, measurement, and reporting. This could potentially inform future proposals for an HRPM-based classification system specifically for pharyngeal swallowing disorders.