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American Journal of Speech-Language Pathology Vol.18 65-73 February 2009. doi:10.1044/1058-0360(2008/06-0061)
© American Speech-Language-Hearing Association
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Research

Evaluation of Manometric Measures During Tongue-Hold Swallows

Sebastian H. Doeltgen
Ulrike Witte
Freya Gumbley
Maggie-Lee Huckabee
The University of Canterbury, and Van der Veer Institute for Parkinson's and Brain Research, Christchurch, New Zealand

Contact author: Sebastian Doeltgen, Swallowing Rehabilitation Research Laboratory, Van der Veer Institute for Parkinson's and Brain Research, 66 Stewart Street, Christchurch, New Zealand. E-mail: shd14{at}student.canterbury.ac.nz.

Purpose: Based on visual inspection, prior research documented increased movement of the posterior pharyngeal wall in healthy volunteers during tongue-hold swallows. This manometric study investigated the immediate effects of the tongue-hold maneuver on pharyngeal peak pressure generation, duration of pressure generation, and pressure slope measurements in healthy volunteers.

Method: Pharyngeal pressures from 40 young, healthy individuals (mean age = 25.8 years, gender equally distributed) were recorded at 3 locations: oropharynx, hypopharynx, and upper esophageal sphincter (UES), during normal control and tongue-hold swallows. Measures of peak amplitude, duration, and slope of pressure generation were subjected to statistical analysis.

Results: Tongue-hold swallows produced lower pharyngeal peak pressure and shorter pharyngeal pressure durations compared to control swallows. Further, tongue-hold swallows produced lower UES relaxation pressures. Between sensors, peak pressure was lower and pressure slopes were steeper in the hypopharynx compared to the oropharynx. Several gender-specific differences were found for pharyngeal peak pressure, pressure duration, and pressure slopes.

Conclusions: Reduced amplitude and duration of pharyngeal peak pressure is likely a result of decreased base of tongue retraction during tongue-hold swallows. Central clinical considerations and future research directions are discussed in this article.

Key Words: deglutition, manometry, biomechanics, tongue-hold maneuver


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