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Effects of Age, Gender, Bolus Condition, Viscosity, and Volume on Pharyngeal and Upper Esophageal Sphincter Pressure and Temporal Measurements During Swallowing

Andrew Stuart
East Carolina University, Greeneville, NC

Donald Castell
Medical University of South Carolina, Charleston, SC

Gregory B. Russell
Kenneth Koch
Shannon Kemp
Wake Forest University School of Medicine

Contact author: Susan G. Butler, Wake Forest University School of Medicine, Department of Otolaryngology Center for Voice and Swallowing Disorders, Medical Center Boulevard, Winston-Salem, NC 27157. E-mail: sbutler{at}wfubmc.edu.

Purpose: The purpose of this study was to determine the effects of trial (i.e., Trial 1 vs. Trial 2); viscosity (i.e., saliva, thin, nectar-thick, honey-thick, and pudding-thick water); volume (i.e., 5 mL vs. 10 mL); age (i.e., young vs. older adults); and gender on pharyngeal (i.e., upper and lower) and upper esophageal sphincter (UES) pressures, durations, and onsets (i.e., onset of upper pharyngeal pressures relative to onsets of UES relaxations and onset of lower relative to upper pharyngeal pressures).

Method: Twenty-three young adults (M = 30 years) and 21 older healthy adults (M = 75 years) participated. Measurements were acquired with a 2.1-mm catheter during simultaneous manometric and endoscopic swallowing assessment. Participants contributed 18 swallows, affording a study total of 792 swallows for analyses.

Results: There was no significant effect of trial on any measurement of pressure, duration, and onset (ps = .63, .39, and .71, respectively). It was found that viscosity, volume, age, and gender affected pressure, duration, and onset measurements (e.g., onset of upper pharyngeal pressures relative to onsets of UES relaxations) but in varying degrees relative to the location in the pharynx or UES and the type of measurement (e.g., pressure, onset).

Conclusions: Manometric measurements vary with respect to age, gender, and bolus variables and interactions of each. Consideration of these variables is paramount in understanding normal and pathological swallowing if manometry is to develop as a quantitative adjunct to videofluoroscopic and endoscopic swallowing tools.

KEY WORDS: swallowing, dysphagia, manometry, age, gender, bolus volume, bolus viscosity

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