Normal pharyngeal and upper esophageal sphincter manometry.

Pharyngeal and upper esophageal sphincter (UES) manometry provides the clinician with an objective means of measuring pharyngeal and UES coordination and quantitative pressures. This modality yields significant information regarding the actual area(s) of swallowing pathophysiology and helps direct specific intervention.

The UES relaxes and opens immediately upon initiation of a swallow, and then a coordinated pharyngeal wave is seen in the more proximal sensors while the UES remains relaxed and open (figure, A). The UES should relax to subatmospheric pressure and then return to baseline. The pressure values vary depending on the width of the manometric catheter (figure, B). By using this technology, the examiner can determine pharyngeal strength and contraction duration, the completeness of UES relaxation, and the coordination between the pharynx and UES during swallowing.