Monitoring of Pharyngeal and Upper Esophageal Sphincter Activity with an Arterial Dilation Balloon Catheter

In patients with dysphagia and radiologic signs of dysfunction of the upper esophageal sphincter (UES), manometry is helpful in giving a better understanding of muscular activity during swallowing. Traditional manometric methods include use of perfusion catheters or solid-state intraluminal strain gauges. The rapid and asymmetric pressure variations in the UES and difficulties compensating for the pharyngolaryngeal elevation during swallowing limit the value of these methods. We used an arterial balloon dilation catheter as a probe in manometric recording of the UES in 28 healthy volunteers. Simultaneous perfusion manometry of the pharynx with the same catheter was performed to assess the coordination of the muscular activity in the esophageal entrance during swallowing. The catheter was well tolerated by all subjects. We found an average resting pressure in the UES of 31.0 mmHg, and the average maximum pressure during contraction was 89.0 mmHg. The average duration of the swallowing act was 3.9 s. All subjects displayed a complete UES relaxation and a normal coordination of propagated pressure in the hypopharynx and UES. The results were highly reproducible and the interindividual range was low. Arterial dilation catheters are safe and have suitable physical properties for pressure monitoring in the UES.