Anatomic-manometric correlation of the upper esophageal sphincter: a concurrent US and manometry study - 24/08/11
Reprint requests: Reza Shaker, MD, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, 9200 Wisconsin Avenue, Milwaukee, WI 53226Résumé |
Background |
The pharyngoesophageal segment commonly referred to as the upper esophageal sphincter (UES) generates a high-pressure zone (HPZ) between the pharynx and the esophagus. However, the exact anatomical components of the UES-HPZ remain incompletely determined.
Objective |
To systematically define the US signature of various components of the pharyngoesophageal junction and to determine how these structures contribute to the development of the UES-HPZ.
Design |
Prospective, experimental study.
Setting |
Tertiary Academic Medical Center.
Patients |
This study involved 18 healthy volunteers.
Intervention |
We studied 5 participants by using a high-frequency US miniprobe (US-MP) and concurrent fluoroscopy and another 13 participants by using the US-MP and concurrent manometry.
Main Outcome Measurements |
Relative contribution of various muscles in the UES-HPZ.
Results |
Manometrically, the UES-HPZ had a median length of 4.0 cm (range 3.0-4.5 cm). A C-shaped muscle, believed to represent the cricopharyngeus muscle, was observed for a median length of 3.5 cm (range 2.0-4.0 cm). The oval configuration representing the esophageal contribution to the UES was seen in 10 of 13 participants (77%) at the distal HPZ (esophagus to UES transition zone). The flat configuration of the inferior constrictor muscle was noted in 7 of 13 participants (54%) at the proximal HPZ (UES to pharynx transition zone). There were 4 to 5 wall layers versus 3 layers in the distal and proximal HPZ, respectively. The mean (± SD) muscle thickness was relatively constant along the length of the UES-HPZ.
Limitations |
Air artifacts in the UES-HPZ.
Conclusion |
The configuration and layers of the UES-HPZ vary along its length. The upper esophagus is a significant contributor to the distal UES-HPZ.
Le texte complet de cet article est disponible en PDF.Abbreviations : HPZ, MMMT, UES, US-MP
Plan
| DISCLOSURE: Drs Shaker, Dua, and Surapaneni were supported by National Institutes of Health grants 5P01DK068051 and 5R01DK025731. All other authors disclosed no other financial relationships relevant to this publication. |
Vol 72 - N° 3
P. 587-592 - septembre 2010 Retour au numéro
Article précédent
- Projected increased growth rate of anesthesia professional–delivered sedation for colonoscopy and EGD in the United States: 2009 to 2015
- John M. Inadomi, Candace L. Gunnarsson, John A. Rizzo, Hai Fang
- Endoscopic submucosal dissection of gastric lesions by using a Master and Slave Transluminal Endoscopic Robot (MASTER)
- Khek-Yu Ho, Soo Jay Phee, Asim Shabbir, Soon Chiang Low, Van An Huynh, Andy Prima Kencana, Kai Yang, Davide Lomanto, Bok Yan Jimmy So, Y.Y. Jennie Wong, S.C. Sydney Chung
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?