What is manometric fluid

Manometric examinations of the oral phase of the act of swallowing - eDiss

dc.contributor.advisorEngelke, Wilfried Prof. Dr. Dr.dc.contributor.authorSantander, Petradc.date.accessioned2013-08-23T09: 38: 43Zdc.date.available2013-08-27T22: 50: 04Zdc.date.issued2013-08-23dc.identifier.urihttp://hdl.handle.net/11858/00-1735-0000-0001-BB2E-Edc.description.abstractSwallowing disorders are increasingly diagnosed in old age and greatly impair the quality of life of the affected patients. An abnormal swallowing pattern in children and adolescents can have a pathological effect on the development of tooth alignment. In this study, the oral phase of swallowing was examined in a healthy group of 52 participants (40 women; 12 m) aged 20 - 45 (mean: 25.48; SD: 4.68) years. For this purpose, an intraoral mouthpiece was used (Silencos®, Bredent, Senden, Germany), which enabled intraoral bolus application and pressure measurement due to the introduction of a silicone loop. The mouthpiece was connected extraorally on the one hand to a syringe filled with liquid for bolus application and on the other hand to a digital manometer (GDUSB 1000®, Greisinger electronics, Regenstauf Germany). The measuring device used was able to carry out measurements at a frequency of 1 kHz in a range from 2000 to -1000 mbar. To protect the test persons and to secure the measurement, a bacteria filter and a water separator were attached to the hose system. With this experimental set-up, three swallowing modalities were investigated. Each modality included 10 swallows. The first study related to the active intake of a bolus of water. The subjects performed suction impulses by drawing liquid from a syringe and then swallowing it. The second and third studies were based on the passive administration of a bolus that was administered in a volume of 2 ml. In this experiment, a 2 ml bolus each of water and gel was administered. In the data collected, mainly negative pressure amplitudes could be observed. A mean value of -290 mbar was measured for active bolus intake, -31 mbar for passive administration of a bolus of water and -37 mbar for passive administration of a bolus of gel. The duration of the swallowing events was also measured. This resulted in an average of 5.1 s for active bolus intake, 1.8 s for passive bolus administration of water and 1.5 s for passive bolus administration of gel. Depending on the type of bolus application and the bolus consistency, significant differences between the recorded pressure amplitudes and pressure curves could be observed. The active intake of a bolus showed higher negative pressure gradients and a longer duration than the passive administration of a bolus. Significant differences between the consistencies could also be observed: the administration of a bolus of gel showed polyphasic curves. In comparison, there were predominantly monophasic curves when swallowing water. The proposed swallowing test was easy to use and could be carried out on all test subjects without any problems. The technical effort was minimal and the investigation did not result in any side effects for the test persons. Based on this test, data sets on the swallowing function were generated, which were evaluated qualitatively and quantitatively and serve as a standard value for future investigations. The interpretation of the collected data on the basis of the biofunctional model enables a methodical recording of the swallowing physiology. A clinical application offers itself as a diagnostic test as well as in exercise therapy. The investigations carried out were able to demonstrate the functional similarity of the functions sucking and swallowing and showed that compartment 2, identified by the biofunctional model, obviously prefers a suction mechanism for the transport of liquids and not a propulsion mechanism by displacing the bolus.dedc.language.isoengdedc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/dc.subject.ddc610dedc.titleManometric examinations of the oral phase of the act of swallowingdedc.typedoctoralThesisdedc.title.translatedIntraoral pressure patterns during swallowingdedc.contributor.refereeCanis, Martin Prof. Dr.dc.date.examination2013-08-27dc.description.abstractengSwallowing disorders become increasingly common with age and can compromise the quality of life. An abnormal swallowing pattern in children and adolescents may have a pathological effect on the development of craniofacial structures. So far, the clinical evaluation of the oral stage of swallowing is limited. The approach of manometry for the evaluation of pressure has increased in recent years, but there are still not enough data regarding normal swallowing function. Therefore, the oral stage of swallowing was assessed in 52 (40w, 12 m) healthy subjects aged between 20 and 45 years (mean 25.48, SD 4.68). For these purposes, an intraoral mouthpiece was used (silencos, Bredent, Senden, Germany), which allowed the intra-oral bolus application and pressure measurement in the subpaltal area. A digital manometer (GDUSB 1000 Greisinger electronics, Regenstauf Germany) able to record pressure variations in a range of 2000 to -1000 mbar at a frequency of 1 kHz was used. With this experimental setup, three modalities were examined: an active bolus intake (where the volunteers cumulate water by suction), a passive application of a 2 ml bolus of water and a passive application of a 2 ml bolus of gel. Each test modality included 10 swallowing repetitions. During the active bolus intake we found an average pressure of -290 mbar and an average duration of the suction-swallowing cycles of 5.1 s. During the passive application of a bolus of water, a pressure average of -31 mbar was measured and a duration of 1.8 s. During the passive application of a bolus of gel the average pressure amplitude observed was -37 mbar with an average duration of 1.5 s. Depending on the bolus application (active or passive) and its consistency (water or gel) significant differences between pressure amplitude and pressure patterns were observed. The active bolus intake showed higher negative pressure characteristics and a longer duration than the passive application of a bolus. Also significant differences between the consistencies were observed: during the administration of a bolus of gel, polyphasic curves were detected in comparison to the passive application of a bolus of water where there were only monophasic curves. A functional similarity between suction and swallowing was observed, since for active as well as for passive application negative pressures predominate. The role of this intraoral negative pressure could be involved in the bolus transport, a mechanism previously described as a piston like motion of the tongue, associated with positive contact pressure. The proposed swallow test showed a simple applicability and could be performed in all subjects. The technical effort was low and implied no side effects. Qualitative and quantitative data was recorded and may serve as a standard value for further investigations. A clinical application of the proposed test relies on diagnostics as well as in therapy.dedc.contributor.coRefereeOppermann, Martin Prof. Dr.dc.subject.gerTo swallowdedc.subject.geroral phasededc.subject.gerPressure measurementdedc.subject.gernegative pressurededc.subject.engswallowingdedc.subject.engoral phasededc.subject.engmanometrydedc.subject.engnegative pressurededc.identifier.urnurn: nbn: de: gbv: 7-11858 / 00-1735-0000-0001-BB2E-E-5dc.affiliation.instituteMedical schooldedc.subject.gokfullMedicine (PPN619874732)dedc.description.embargoed2013-08-27dc.identifier.ppn766249034