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Am J Physiol Gastrointest Liver Physiol (September 8, 2005). doi:10.1152/ajpgi.00011.2005
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Submitted on January 11, 2005
Accepted on August 25, 2005

Assessment of Intraluminal Impedance for the Detection of Pharyngeal Bolus Flow During Swallowing in Healthy Adults

Taher I. Omari1*, Nathalie Rommel2, Michal M. Szczesniak3, Sergio Fuentealba3, Philip G. Dinning3, Geoffrey P. Davidson1, and Ian J. Cook3

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

* To whom correspondence should be addressed. E-mail: taher.omari{at}adelaide.edu.au.

Intraluminal impedance, a non-radiological 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 pharyngo-esophageal 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 were 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 UES and proximal esophagus, the timing of impedance recovery correlated well with the timing of clearance of the bolus tail. Impedance-based estimates of pharyngo-esophageal bolus clearance time correlated with true pharyngo-esophageal bolus clearance time. Patterns of intraluminal impedance recorded in the pharynx during bolus swallowing are therefore more complex than 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.







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