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Am J Physiol Gastrointest Liver Physiol 281: G1290-G1300, 2001;
0193-1857/01 $5.00
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Vol. 281, Issue 5, G1290-G1300, November 2001

Space-time pressure structure of pharyngo-esophageal segment during swallowing

Rohan B. Williams1, Anupam Pal2, James G. Brasseur2, and Ian J. Cook1

1 Department of Gastroenterology, St. George Hospital and University of New South Wales, Sydney, Australia 2217; and 2 Department of Mechanical Engineering, Pennsylvania State University, University Park, Pennsylvania 16802

We applied high-resolution manometry with spatiotemporal data interpolation and simultaneous videofluoroscopy to normal pharyngeal swallows to correlate specific features in the space-time intraluminal pressure structure with physiological events and normal deglutitive transsphincteric bolus flow to define normal biomechanical properties of the pharyngo-esophageal (PE) segment. Pressures were recorded by microperfused catheter, and the two-dimensional space-time data sets were plotted as isocontours. On these were superimposed bolus trajectories, anatomic segment movements, and hyo-laryngeal trajectories from concurrent videofluoroscopy. Correlation of the highly reproducible space-time-pressure structure with radiographic images confirmed that primary deglutitive PE segment functions (pressure profile, laryngeal elevation, axial sphincter motion, timing of relaxation, contraction) are accurately discernible from single isocontour pressure visualization. Pressure during bolus flow was highly dependent on axial location within PE segment and time instant. The intrabolus pressure domain, corresponding to the space-time region between bolus head and tail trajectories, demonstrated significant bolus volume dependence. High-resolution manometry accurately, comprehensively, and highly reproducibly depicts the PE segment space-time-pressure structure and specific physiological events related to upper esophageal sphincter opening and transsphincteric flow during normal swallowing. Intrabolus pressure variations are highly dependent on position within the PE segment and time.

bolus transport; deglutition; pharynx; cricopharyngeus; sphincter; fluoroscopy; mechanics; upper esophageal sphincter


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