PMID- 35372473
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220405
IS  - 2296-875X (Print)
IS  - 2296-875X (Electronic)
IS  - 2296-875X (Linking)
VI  - 9
DP  - 2022
TI  - Applying High-Resolution Impedance Manometry for Detecting Swallowing Change in 
      Anterior Cervical Spine Surgery Patients.
PG  - 851126
LID - 10.3389/fsurg.2022.851126 [doi]
LID - 851126
AB  - BACKGROUND: Objectively detecting perioperative swallowing changes is essential 
      for differentiating the reporting of subjective trouble sensations in patients 
      undergoing anterior cervical spine surgery (ACSS). Swallowing indicates the 
      transmission of fluid boluses from the pharynx (velopharynx, oropharynx, and 
      hypopharynx) through the upper esophageal sphincter (UES). Abnormal swallowing 
      can reveal fluid accumulation at the pharynx, which increased the aspiration 
      risk. However, objective evidence is limited. High-resolution impedance manometry 
      (HRIM) was applied for an objective swallowing evaluation for a more detailed 
      analysis. We aimed to elucidate whether HRIM can be used to detect perioperative 
      swallowing changes in patients undergoing ACSS. METHODS: Fourteen patients 
      undergoing elective ACSS underwent HRIM with the Dysphagia Short Questionnaire 
      (DSQ, score: 0-18) preoperatively (PreOP), on postoperative at day 1 (POD1), and 
      postoperative at day seven (POD7). We calculated hypopharyngeal and UES 
      variables, including hypopharyngeal mean peak pressure (PeakP) and UES peak 
      pressure, representing their contractility (normal range of PeakP, 69-280 mmHg; 
      peak pressure, 149-548 mmHg). The velopharynx-to-tongue base contractile (VTI) 
      was also calculated (normal range, 300-700 mmHg.s.cm), indicating contractility. 
      The swallowing risk index (SRI) from HRIM combined with four hypopharyngeal 
      parameters, including PeakP, represents the global swallowing function (normal 
      range, 0-11). A higher SRI value indicated higher aspiration. RESULTS: SRI was 
      significantly higher on POD1 (10.88 +/- 5.69) than PreOP (6.06 +/- 3.71) and POD7 
      (8.99 +/- 4.64). In all patients, PeakP was significantly lower on POD1 (61.8 +/- 
      18.0 mmHg) than PreOP (84.9 +/-34.7 mmHg) and on POD7 (75.3 +/- 23.4 mmHg). The UES 
      peak pressure was significantly lower on POD1 (80.4 +/- 30.0 mmHg) than PreOP 
      (112.9 +/- 49.3 mmHg) and on POD7 (105.6 +/- 59.1 mmHg). Other variables, including 
      VTI, did not change significantly among the three time points. DSQ scores were 
      1.36, 3.43, and 2.36 at PreOP, POD1, and POD7 respectively. CONCLUSIONS: With 
      similar trends in DSQ and SRI, swallowing was significantly decreased on POD1 
      because of decreased hypopharyngeal and UES contractility but recovered to the 
      preoperative state on POD7 after ACSS. Applying HRIM is superior to DSQ in 
      detecting mechanisms and monitoring the recovery from swallowing dysfunction. 
      CLINICAL TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov 
      (NCT03891940).
CI  - Copyright (c) 2022 Lai, Cheng, Lai, Wu, Chang and Tsuang.
FAU - Lai, Chih-Jun
AU  - Lai CJ
AD  - Institute of Epidemiology and Preventive Medicine, National Taiwan University, 
      Taipei, Taiwan.
AD  - Department of Anesthesiology, National Taiwan University Hospital, Taipei, 
      Taiwan.
FAU - Cheng, Ya-Jung
AU  - Cheng YJ
AD  - Department of Anesthesiology, College of Medicine, National Taiwan University, 
      Taipei, Taiwan.
AD  - Department of Anesthesiology, National Taiwan University Cancer Center, Taipei, 
      Taiwan.
FAU - Lai, Dar-Ming
AU  - Lai DM
AD  - Division of Neurosurgery, Department of Surgery, National Taiwan University 
      Hospital, Taipei, Taiwan.
FAU - Wu, Chun-Yu
AU  - Wu CY
AD  - Department of Anesthesiology, National Taiwan University Hospital, Taipei, 
      Taiwan.
FAU - Chang, Wen-Ting
AU  - Chang WT
AD  - Department of Anesthesiology, National Taiwan University Hospital, Taipei, 
      Taiwan.
FAU - Tsuang, Fon-Yih
AU  - Tsuang FY
AD  - Division of Neurosurgery, Department of Surgery, National Taiwan University 
      Hospital, Taipei, Taiwan.
LA  - eng
SI  - ClinicalTrials.gov/NCT03891940
PT  - Journal Article
DEP - 20220316
PL  - Switzerland
TA  - Front Surg
JT  - Frontiers in surgery
JID - 101645127
PMC - PMC8965755
OTO - NOTNLM
OT  - anterior cervical spine surgery
OT  - high-resolution impedance manometry
OT  - hypopharynx
OT  - perioperative swallowing physiology
OT  - upper esophageal sphincter
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/04/05 06:00
MHDA- 2022/04/05 06:01
PMCR- 2022/03/16
CRDT- 2022/04/04 05:33
PHST- 2022/01/10 00:00 [received]
PHST- 2022/02/16 00:00 [accepted]
PHST- 2022/04/04 05:33 [entrez]
PHST- 2022/04/05 06:00 [pubmed]
PHST- 2022/04/05 06:01 [medline]
PHST- 2022/03/16 00:00 [pmc-release]
AID - 10.3389/fsurg.2022.851126 [doi]
PST - epublish
SO  - Front Surg. 2022 Mar 16;9:851126. doi: 10.3389/fsurg.2022.851126. eCollection 
      2022.