Effect of Body Position on Pharyngeal Swallowing Pressures Using High-Resolution Manometry

AbstractThe effect of body position and gravitational pull on the complex pressure-driven process of pharyngeal swallowing remains unknown. Using high-resolution manometry (HRM), this study aims to identify positional adaptations of pharyngeal physiology by evaluating swallowing pressure patterns in a series of inverted body positions. Ten healthy adults each underwent swallowing tasks with pharyngeal HRM at six body positions using an inversion table  (0°[upright], 45°, 90°[supine], 110°, 135°, and 180°[fully inverted]). Repeated measures ANOVA was used to assess impact of position on pressure parameters, and pharyngeal-UES pressure gradients translate. Velopharyngeal pressures varied by position (P <  0.001), with significantly higher pressures generated with inversion ≥90°, compared with upright and 45°. Change in position did not significantly affect common mesopharyngeal pressures or swallowing pressure durations. UES valving mechanisms were preserved during inversion, with subtle variat ions observed in integral pressures (P = 0.011). Pharyngeal-UES pressure gradients changed with position (P <  0.01), increasing with inversion >  90° compared to upright and 45°. Mechanisms of deglutition may differ with position and relative direction of gravity, particularly when at >  45° inclination. Increased palatal pressure is generated in the upside-down position to achieve nasopharyngeal closure and prevent regurgitation. While other classica...
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research