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Implementation of High-resolution Manometry in the Clinical Practice of Speech Language Pathology

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Abstract

Visual imaging modalities, videofluoroscopic swallow study (VFSS) and fiberoptic endoscopic evaluation of swallow, for assessment of oropharyngeal dysphagia have been part of the speech language pathologist’s (SLPs) armamentarium for the diagnosis and treatment of dysphagia for decades. Recently, the addition of high-resolution manometry (HRM) has enabled the SLP to evaluate pharyngeal pressures and upper esophageal sphincter relaxation. Taken together, the use of visual imaging modalities with HRM can improve interpretation of swallowing physiology and facilitate more effective treatment planning. The goal of this article is to describe a clinical paradigm using HRM as an adjunct to VFSS, by the SLP, in the assessment of complex dysphagia. Moreover, in three cases described, the value of manometric measurements in elucidating swallowing imaging studies and documenting physiologic change in response to treatment is highlighted. As technology in this area is evolving, so will the clinical use of HRM by the SLP. Limitations of current HRM systems and applications are discussed.

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Acknowledgments

This work was funded in part from the Diane M Bless Endowed Chair, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin Madison and from the NIDCD grant NIH 4 R33 DC011130-03.

Conflict of interest

The authors have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin – Madison, 600 Highland Avenue, Madison, WI, 53792, USA

    Molly A. Knigge, Susan Thibeault & Timothy M. McCulloch

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  1. Molly A. Knigge
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  2. Susan Thibeault
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  3. Timothy M. McCulloch
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Correspondence to Molly A. Knigge.

Appendix: Competency in HRM

Appendix: Competency in HRM

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Knigge, M.A., Thibeault, S. & McCulloch, T.M. Implementation of High-resolution Manometry in the Clinical Practice of Speech Language Pathology. Dysphagia 29, 2–16 (2014). https://doi.org/10.1007/s00455-013-9494-5

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  • DOI: https://doi.org/10.1007/s00455-013-9494-5

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