Use of Pharyngeal High-Resolution Manometry to Evaluate Dysphagia in Adults with Motor Neurone Disease: A Scoping Review.
Eva Mary Diver, Julie Regan
PMID 35235032WHAT IT FOUND
Pharyngeal manometry appears feasible in motor neurone disease, with no adverse events reported in five studies.
However, inconsistent protocols and tiny samples prevent firm conclusions on its clinical value or specific physiological findings.
Key findings
01Five of the six included studies reported a 100% completion rate for the assessment, with no adverse events documented.
02Significant variability exists in the manometry equipment, protocols, and analysis methods used across the included studies, which limits the ability to compare results.
03When compared to healthy controls, people with MND showed reduced pressure in the pharynx and evidence of upper oesophageal sphincter restriction.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The review included only six studies, with half having two or fewer participants, resulting in very small sample sizes. There was considerable variability in PHRM equipment, catheter dimensions, bolus volumes, and analysis methods, which restricts the comparability of findings across studies. Most studies did not document patient-reported outcomes or tolerability of the invasive assessment, despite the potential for discomfort in patients with hyperactive gag reflexes. The evidence for intervention effects is derived from very small numbers (one to 16 participants) and cannot confirm efficacy. Four of the six studies were published before recent international working group recommendations for PHRM protocols, contributing to the methodological heterogeneity.
Declared interests
The work was funded by the University of Dublin, Trinity College. No other conflicts of interest are reported.
The easy way to misread this
Do not interpret the physiological findings (such as reduced pharyngeal pressure) as definitive diagnostic criteria or stable norms for all patients. The results are drawn from a very small number of studies with highly variable testing protocols, and the assessment's impact on patient comfort was largely unreported.