口咽吞咽困难(OD)是一种在不同患者表型中患病率很高的病理。近年来,具有阻抗的高分辨率咽食管测压(HRPM)(HRPM-I)已成为更好地了解OD患者咽和上食管括约肌(UES)功能障碍的病理生理学的基本技术。各种专家组提出了一种方法,用于HRPM-I的实践以及基于三种主要现象的量化来研究咽运动和UES功能障碍的不同指标的标准化:UES的松弛,通过UES的流动阻力和推注通过咽部进入食道的推进。根据这些指标的变化,提出了三种功能障碍模式,可以采用特定的治疗方法:a)正常咽部推进的UES流量限制,b)咽部推进无效的UES流量限制,和c)无效的咽部收缩与UES的正常松弛。我们对主要工作组使用的方法和指标进行了实际审查,并根据我们的经验描述了功能障碍的主要模式,以强调HRPM-I在病理生理学研究和选择中的有用性。OD患者的特定治疗。
Oropharyngeal dysphagia (OD) is a pathology with a high prevalence in different patient phenotypes. High-resolution pharyngoesophageal manometry (HRPM) with impedance (HRPM-I) has become in recent years a fundamental technique for better understanding the pathophysiology of pharynx and upper oesophageal sphincter (UES) dysfunctions in patients with OD. Various groups of experts have proposed a methodology for the practice of the HRPM-I and for the standardization of the different metrics for the
study of pharyngeal motility and UES dysfunctions based on the quantification of 3main phenomena: relaxation of the UES, resistance to flow through the UES and propulsion of the bolo through the pharynx into the oesophagus. According to the alterations of these metrics, 3patterns of dysfunction are proposed that allow a specific therapeutic approach: (a) UES flow restriction with normal pharyngeal propulsión; (b) UES flow restriction with ineffective pharyngeal propulsion, and (c) ineffective pharyngeal contraction with normal relaxation of the UES. We present a practical review of the methodology and metrics used by the main working groups together with the description of the main patterns of dysfunction according to our experience to highlight the usefulness of the HRPM-I in the
study of the pathophysiology and selection of a specific treatment in patients with OD.