Study of Swallowing Pressure for Diagnostic Purposes

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The purposes of the present study are to devise the standardization of measuring the swallowing pressure and to clarify the diagnostic values of this method in case of dysphagia. The swallowing pressure measured using a micro-tip pressure transducer and the elctromyograms recorded from the suprahyoidal muscles were digitalized through an A/D converter and were fed into floppy discs. The data stored in the discs were reproduced on a CRO through a personal computer and various parameters were calculated using a self-made program. The normal ranges of the following three parameters were investigated: the swallowing pressure curve, the conduction velocity of swallowing pressure and the duration of relaxation of the upper high pressure zone of the esophagus (UHPZ). The swallowing pressure curve was obtained by connecting the peaks of the pressure in the pharyngeal and esophageal cavities. The patients with a slight degree of dysphagia showed the increase of the swallowing pressure and, on t … More he other hand, the patients with a moderate or severe degree of dysphagia showed the decrease of the pressure. To visualize normal or abnormal patterns of conduction of the swallowing pressure, the conduction curve of the swallowing pressure was proposed. In this curve, the abscissa expressed the timing of the peak of the swallowing pressure and the ordinate the distance from the naris. The curve was an S-like figure in normal subjects, since the conduction velocity was relatively slow at the velopharyngeal part, rapid at the meso- and hypo-pharyngies and slow at the esophageal orifice. When the conduction curve was deviated from the normal pattern, a disorder of the central deglutitatory system was suggested. The intraluminal pressure at UHPZ in deglutition remained at the level of atmospheric pressure for longer than 500 msec. When this duration was shorter than 500 msec, an incomplete relaxation of the esophageal orifice was suggested. In conclusion, the measurement of the swallowing pressure could offer quantitative and qualitative evaluations of swallowing function and, in addition, the choice of treatment method was feasible by analyzing the above three parameters. Less