Defining Pharyngeal and Upper Esophageal Sphincter Disorders on High-Resolution Manometry-Impedance: The Leuven Consensus.

IF 2.9 3区医学 Q1 CLINICAL NEUROLOGY Neurogastroenterology and Motility Pub Date : 2025-04-09 DOI:10.1111/nmo.70042

Taher I Omari, Julia C F Maclean, Charles Cock, Timothy M McCulloch, Nogah Nativ-Zeltzer, Ashli K O'Rourke, Michal M Szczesniak, Peter I Wu, Jacqueline Allen, Yoichiro Aoyagi, Howell Henrian G Bayona, Silvia Carrión, Michelle R Ciucci, Kate Davidson, Shumon I Dhar, Shaheen Hamdy, Rebecca Howell, Corrine Jones, Molly A Knigge, An Moonen, Gregory N Postma, Jo Puntil-Sheltman, Anais Rameau, Julie Regan, Mistyka Schar, Nathalie Rommel

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Abstract

Introduction: The Leuven Consensus provides a classification scheme for the diagnosis of pharyngeal and upper esophageal sphincter (UES) motor disorders using metrics derived from pharyngeal high-resolution manometry-impedance (P-HRM-I).

Methods: Twenty-six experts with broad multidisciplinary backgrounds contributed their knowledge and experience to this initiative via a formal deliberative Delphi process. Guidance on a swallow assessment protocol as well as diagnostic criteria for UES dysfunction and pharyngeal contractile dysfunction is provided.

Results: For UES dysfunction, the stepwise evaluation of UES and intrabolus pressure metrics under increasing bolus volume and/or viscosity conditions is used to confirm failure of manometric relaxation and opening of the UES region. For pharyngeal contractile dysfunction, the evaluation of contractile metrics is used to define pharyngeal hypocontractility or hypercontractility.

Conclusion: These recommendations complement routine instrumental investigations and provide a standardized process, criteria, and nomenclature for P-HRM-I assessment of patients reporting symptoms of oropharyngeal dysphagia.

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用高分辨率测压阻抗法定义咽和食管上括约肌疾病：鲁汶共识。

鲁汶共识提供了一种分类方案，用于使用咽高分辨率测压阻抗（P-HRM-I）得出的指标来诊断咽和食管上括约肌（UES）运动障碍。方法：26名具有广泛多学科背景的专家通过正式审议德尔菲程序为这一倡议贡献了他们的知识和经验。指导吞咽评估方案以及诊断标准的UES功能障碍和咽收缩功能障碍提供。结果：对于UES功能障碍，在增加容积和/或粘度条件下逐步评估UES和内压力指标用于确认压力松弛失败和UES区域开放。对于咽部收缩功能障碍，评估收缩指标用于定义咽部收缩不足或收缩过度。结论：这些建议补充了常规仪器检查，并为报告口咽吞咽困难症状的患者的p - hrm - 1评估提供了标准化的过程、标准和术语。

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来源期刊

Neurogastroenterology and Motility 医学-临床神经学

CiteScore

7.80

自引率

8.60%

发文量

178

审稿时长

3-6 weeks

期刊介绍： Neurogastroenterology & Motility (NMO) is the official Journal of the European Society of Neurogastroenterology & Motility (ESNM) and the American Neurogastroenterology and Motility Society (ANMS). It is edited by James Galligan, Albert Bredenoord, and Stephen Vanner. The editorial and peer review process is independent of the societies affiliated to the journal and publisher: Neither the ANMS, the ESNM or the Publisher have editorial decision-making power. Whenever these are relevant to the content being considered or published, the editors, journal management committee and editorial board declare their interests and affiliations.