Methods for assessing swallowing motor function

a motor function and esophageal technology, applied in the field of pharyngeal and/or esophageal motor function assessment, can solve the problems of ineffective swallowing, dysphagia, and the tendency of radiotherapy and chemotherapy to weaken the muscles of the muscles, and achieve the effect of reducing the number of patients and improving the quality of li

Inactive Publication Date: 2013-11-07
WOMENS & CHILDRENS HEALTH RES INST
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0015]The present invention is predicated in part on the finding that manometry and impedance data obtained from a subje...

Problems solved by technology

When motor function is compromised, difficulty in swallowing (dysphagia) arises and an ineffective swallow ensues.
In addition, radiotherapy and chemotherapy associated with cancer treatment tends to weaken the muscles and degrade the nerves associated with the physiology and nervous innervation of the swallow reflex.
Dysphagia is often accompanied by aspiration due to ineffective airway protection during oropharyngeal swallowing.
Furthermore, aspiration can lead to recurrent pneumonia, progressive lung disease, and respiratory disability.
Therefore aspiration is a serious condition which can, if undetected, result in severe complications and potentially death.
Accordingly, dysphagia and pulmonary aspiration represent significant clinical, social, and economic costs and issues.
This hinders the provision of adequate nutrition, affecting growth and development leading to significant parental anxiety and family disruption.
Despite the significantly high prevalence of swallowing disorders and associated complications, the current methods for the assessment of swallowing and for the evaluation of direct aspiration are far from optimal.
Such disorders lead to ineffective pharyngeal bolus clearance and/or aspiration.
The use of manometry for assessment of aspiration risk has been very limited in routine clinical practice.
This is because manometric criteria alone have not been shown to accurately assess risk of aspiration and/or post-swallow bolus residue.
Although intraluminal impedance measurement has emerged in recent years as a technique that can be used to detect failed esophageal bolus transport, the application of impedance measurement to examine pharynx moto...

Method used

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  • Methods for assessing swallowing motor function
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  • Methods for assessing swallowing motor function

Examples

Experimental program
Comparison scheme
Effect test

example 1

Assessment of Pharyngeal Motor Function Relevant to Aspiration—Adults

[0224]The aim of this study was to develop a new approach for the objective assessment of pharyngeal mechanical function relevant to aspiration. This used high resolution intraluminal manometry combined with impedance measurement (herein referred to as manometry and impedance). These data were explored for criteria that would enable recognition of individuals at high risk for clinically significant aspiration, without performance of fluoroscopy.

Methods

Subjects

[0225]Twenty subjects (13 male, mean 68.2 years, range 30-95 yrs) were studied. These subjects had been referred to a swallowing clinic for a videomanometric study of the pharynx and oesophagus because of clinical suspicion of deglutitive aspiration due to a deglutition disorder. Underlying diseases / conditions were identified through a review of medical records. The majority of subjects had a history of neurological disease or neurosurgery (FIG. 1). For compar...

example 2

[0254]Assessment of Pharyngeal Motor Function Relevant to Aspiration—Children

[0255]The aim of this study was to apply the approach developed in Example 1, i.e. the use of high resolution intraluminal manometry combined with impedance measurement, for the objective assessment of pharyngeal function relevant to aspiration in infants and children. This approach was evaluated to determine if it enables recognition of paediatric patients at high risk for clinically significant aspiration, without performance of fluoroscopy.

Methods

Subjects

[0256]Eleven paediatric dysphagic patients (mean 6 years, range 5 months-13.4 years) were referred for a videomanometry study of the pharynx and esophagus. Underlying diseases / conditions were identified through a review of medical records. The majority of patients had a neurological history (FIG. 9).

Measurement Technique

[0257]All fluoroscopy studies were performed in the Paediatric Radiology Department, University Hospitals Leuven. Studies were performed...

example 3

Assessment of Pharyngeal Motor Function Relevant to Post-Swallow Bolus Residue

[0266]The aim of this study was to apply the approach developed in Example 1, i.e. the use of high resolution intraluminal manometry combined with impedance measurement, for the objective assessment of pharyngeal function relevant to post-swallow bolus residue. This approach was evaluated to determine if it enables recognition of subjects with swallowing dysfunction causing bolus residue, without performance of fluoroscopy.

Methods

Subjects

[0267]23 dysphagic patients (17 adults, 6 children, 14 males, mean age 55 years, age range 2-95 years) were referred to the paediatric and adult swallowing clinics for a videomanometry study of the pharynx and esophagus. Underlying diseases / conditions were identified through a review of medical records. Sixteen patients had a neurological history comprising 7 adults with stroke, 4 children with cerebral palsy, 2 adults with Parkinson's disease, 2 adults with dementia and 1...

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PUM

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Abstract

The present invention relates to methods for assessing swallowing motor function in a subject. The methods rely on obtaining intraluminal impedance and pressure measurements from the pharynx and/or esophagus of the subject during clearance of a bolus from the mouth and/or throat of the subject. The intraluminal impedance and pressure measurements are combined to derive a value for one or more pressure-flow variables in the pharynx and/or esophagus of the subject. The value of the one or more pressure-flow variables is compared to a predetermined pharyngeal and/or esophageal reference value for the one or more pressure-flow variables in order to provide an assessment of swallowing motor function in the subject. The intraluminal impedance and pressure measurements can also be combined to generate a swallow risk index for the subject or to generate an obstructive risk index for the subject based on a combination of a value of more than one pressure-flow variable in the pharynx and/or esophagus of the subject. In this way, swallowing motor function in the subject can be assessed by comparing the swallow risk index or obstructive risk index for the subject to a predetermined reference swallow index or predetermined reference obstructive index, respectively. Products which make use of these methods are also encompassed by the present invention.

Description

PRIORITY CLAIM[0001]This international patent application claims priority to Australian provisional patent application 2010904104 filed on 13 Sep. 2010, and to Australian provisional patent application 2011902359 filed on 16 Jun. 2011, the contents of which are herein incorporated by reference.FIELD OF THE INVENTION[0002]The present invention relates generally to methods for assessing pharyngeal and / or esophageal motor function in a subject during swallowing. The methods may be used to identify ineffective swallowing in the subject, including ineffective swallowing due to an obstruction, and may further be used to determine risk of aspiration in the subject.BACKGROUND OF THE INVENTION[0003]Swallowing is a complex process which involves a number of interdependent and coordinated phases. Generally, these include the preparatory, oral, pharyngeal and esophageal phases indicative of the anatomic regions traversed by a swallowed food and / or liquid bolus. During the preparatory phase, a f...

Claims

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Application Information

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IPC IPC(8): A61B5/00
CPCA61B5/4205A61B5/037A61B5/7235A61B5/7282A61B5/036A61B5/0538A61B5/7275G16H50/30G16H40/63G16H50/20G16H20/40A61B5/038A61B5/053
Inventor OMARI, TAHER IMADROMMEL, NATHALIE
Owner WOMENS & CHILDRENS HEALTH RES INST
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