Safety and Tolerability of Pharyngeal High-Resolution Manometry Purpose Pharyngeal high-resolution manometry is an emerging practice for diagnosis of swallowing disorders in the upper aerodigestive tract. Advancement of a catheter through the upper esophageal sphincter may introduce safety considerations. There are no published studies of catheter placement complications, side effects, or tolerability. This study examines patient-reported side effects ... Research Article
Newly Published
Research Article  |   December 04, 2018
Safety and Tolerability of Pharyngeal High-Resolution Manometry
 
Author Affiliations & Notes
  • Molly A. Knigge
    University of Wisconsin–Madison
  • Stevie Marvin
    University of Wisconsin–Madison
  • Susan L. Thibeault
    Department of Surgery, University of Wisconsin–Madison
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Molly A. Knigge: knigge@surgery.wisc.edu
  • Editor-in-Chief: Julie Barkmeier-Kraemer
    Editor-in-Chief: Julie Barkmeier-Kraemer×
  • Editor: Debra Suiter
    Editor: Debra Suiter×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Newly Published / Research Article
Research Article   |   December 04, 2018
Safety and Tolerability of Pharyngeal High-Resolution Manometry
American Journal of Speech-Language Pathology, Newly Published. doi:10.1044/2018_AJSLP-18-0039
History: Received February 28, 2018 , Revised June 21, 2018 , Accepted July 9, 2018
 
American Journal of Speech-Language Pathology, Newly Published. doi:10.1044/2018_AJSLP-18-0039
History: Received February 28, 2018; Revised June 21, 2018; Accepted July 9, 2018

Purpose Pharyngeal high-resolution manometry is an emerging practice for diagnosis of swallowing disorders in the upper aerodigestive tract. Advancement of a catheter through the upper esophageal sphincter may introduce safety considerations. There are no published studies of catheter placement complications, side effects, or tolerability. This study examines patient-reported side effects and tolerability of pharyngeal high-resolution manometry.

Method Data were collected prospectively from 133 adult patients who underwent pharyngeal high-resolution manometry for the 1st time. Patients rated tolerability specific to “nose” and “throat” using a visual analog scale for 4 procedure time points: catheter passage, during the procedure, catheter removal, and after the procedure. Complications during catheter passage and removal were recorded. A telephone call was placed to the patient within 6 days to survey side effects experienced after the procedure.

Results The patient sample was composed of 91 males and 42 females with a mean age of 66 years (SD = 14.4). Tolerability scores for catheter passage showed no significant difference (p = .7288) in the nose versus throat. Tolerability for females was significantly less (p = .0144) than that for males. Participants with the shortest procedure duration showed greatest discomfort in the nose (p = .0592) and throat (p = .0286). Complications included gag response (14%), emesis (2%), and epistaxis (< 1%). Side effects included sore throat (16%), nose discomfort (16%), coughing (11 %), nosebleed (4%), and nausea/vomiting (4%).

Conclusions High-resolution manometry appears to have high patient tolerability with low incidence of side effects. Rates of complications and side effects are similar to those reported for other transnasal procedures.

Acknowledgments
This work was funded in part by the Diane M. Bless Endowed Chair, Division of Otolaryngology–Head & Neck Surgery, University of Wisconsin–Madison. The authors thank biostatisticians Xing Wang and Dou-Yan Yang, Department of Surgery, University of Wisconsin–Madison. Author contributions are as follows: Molly A. Knigge initiated study concept and design; supervised and contributed to the acquisition of data; did statistical analysis for proportional calculations, the analysis and interpretation of data, and the drafting of the article; and contributed to the critical revision of the article for intellectual content and study supervision in the clinical setting. Stevie Marvin participated in the study design, contributed to the acquisition of data, assisted in the interpretation of data, and contributed to the critical revision of the article for intellectual content. Susan Thibeault did the oversight of the study concept and design; guided the analysis and interpretation of data; contributed to the critical revision of the article for intellectual content; did administrative and clinical study supervision; did administrative, technical, and material support for this clinical research; and obtained funding.
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