Investigation of swallowing physiology and swallowing problem (dysphagia) have mainly been conducted by fluoroscopic, endoscopic and electrophysiological examinations that focus on the movements of structures, or contraction of superficial muscles. The muscle morphometry, deeper muscular movement and the pressure generated by them, important factors in safety and efficiency of swallow, have not been extensively investigated until the emergence of two tools in oropharyngeal dysphagia management.
Ultrasound (USG) has a long history in diagnostics and rehabilitation. In dysphagia management, it has been mostly used to measure tissue morphometry and swallowing kinematics, among others. It has the advantage of being non-invasive and portable, suitable for use in clinic and in-patient settings. HRPM with impedance is able to reveal the dyanmic action of the pharynx, upper esophageal sphincter and the esophagus in conjunction with bolus flow. It has the advantage of being able to provide quantitative data on various consistencies of liquid and food. Normative data are also becoming more available for comparison in recent years.
Measurements by USG and HRPM have been demonstrated to be associated with events that affect the safety and efficiency of swallowing, such as residue and aspiration events. They are becoming more common as diagnostic tools or tools for measuring treatment outcome.
In this presentation, updated literature on USG and HRPM will be presented. In particular, a HRPM protocol and metrics proposed by an international working group and its application in local context will be discussed. The presentation will also feature selected cases highlighting the use of USG and HRPM in clinical context, how it was able to facilitate decision making and measuring treatment outcomes. The implication of how USG and HRPM will affect dysphagia management will also be briefly discussed.
