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This Article Full Text Full Text (PDF) All Versions of this Article: 290/1/G183    most recent 00011.2005v2 00011.2005v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Omari, T. I. Articles by Cook, I. J. Search for Related Content PubMed PubMed Citation Articles by Omari, T. I. Articles by Cook, I. J.

INNOVATIVE METHODOLOGY

Assessment of intraluminal impedance for the detection of pharyngeal bolus flow during swallowing in healthy adults

¹Department of Paediatrics, University of Adelaide, and ²Centre for Paediatric and Adolescent Gastroenterology, Women's and Children's Hospital, Adelaide, South Australia; and ³Department of Gastroenterology, St. George Hospital, University of New South Wales, Sydney, New South Wales, Australia

Submitted 11 January 2005 ; accepted in final form 25 August 2005

Intraluminal impedance, a nonradiological method for assessing bolus flow within the gut, may be suitable for investigating pharyngeal disorders. This study evaluated an impedance technique for the detection of pharyngeal bolus flow during swallowing. Patterns of pharyngoesophageal pressure and impedance were simultaneously recorded with videofluoroscopy in 10 healthy volunteers during swallowing of liquid, semisolid, and solid boluses. The timing of bolus head and tail passage recorded by fluoroscopy was correlated with the timing of impedance drop and recovery at each recording site. Bolus swallowing produced a drop in impedance from baseline followed by a recovery to at least 50% of baseline. The timing of the pharyngeal and esophageal impedance drop correlated with the timing of the arrival of the bolus head. In the pharynx, the timing of impedance recovery was delayed relative to the timing of clearance of the bolus tail. In contrast, in the upper esophageal sphincter (UES) and proximal esophagus, the timing of impedance recovery correlated well with the timing of clearance of the bolus tail. Impedance-based estimates of pharyngoesophageal bolus clearance time correlated with true pharyngoesophageal bolus clearance time. Patterns of intraluminal impedance recorded in the pharynx during bolus swallowing are therefore more complex than those in the esophagus. During swallowing, mucosal contact between the tongue base and posterior pharyngeal wall prolongs the duration of pharyngeal impedance drop, leading to overestimation of bolus tail timing. Therefore, we conclude that intraluminal impedance measurement does not accurately reflect the bolus transit in the pharynx but does accurately reflect bolus transit across the UES and below.

dysphagia; diagnosis; pharyngeal function