{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T16:28:19Z","timestamp":1756571299645,"version":"3.40.5"},"reference-count":48,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T00:00:00Z","timestamp":1698883200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The sequential generation of swallowing pressure (SP) from the nasopharynx to the proximal esophagus is important for the bolus to pass from the oral cavity to the esophagus. The purpose of this study was to investigate the correlation of the SP sequence mode on high\u2010resolution manometry (HRM) with oral intake difficulty and aspiration pneumonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients with dysphagia who were admitted to our dysphagia clinic between November 2016 and November 2020 were enrolled in this cross\u2010sectional study. We classified the HRM pressure topography data according to the SP sequence mode into type A, normal; B, partially decreased; C, totally decreased; and D, sequence disappeared, and according to the upper esophageal sphincter (UES) during pharyngeal swallowing into type 1, flattening and 2, non\u2010flattening. Clinical dysphagia severity was determined based on oral intake difficulty and aspiration pneumonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 202 patients with dysphagia (mean [standard deviation] age, 68.3 [14.5] years; 140 [69.8%] male) were enrolled. Type C (odds ratio [OR], 10.48; 95% confidence interval [CI], 2.89\u201351.45), type D (OR, 19.90; 95% CI, 4.18\u2013122.35), and type 2 (OR, 6.36; 95% CI, 2.88\u201314.57) were significantly related to oral intake difficulty. Type C (OR, 3.23; 95% CI, 1.08\u201311.12) and type 2 (OR, 4.18; 95% CI, 1.95\u20139.15) were significantly associated with aspiration pneumonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The failure of sequential generation of SP was associated with higher risk of oral intake difficulty and aspiration pneumonia. These assessments are useful in understanding the pathophysiology and severity of dysphagia and in selecting safety nutritional management methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 134:2127\u20132135, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31155","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T12:45:23Z","timestamp":1698929123000},"page":"2127-2135","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Oral Intake Difficulty and Aspiration Pneumonia Assessment Using High\u2010Resolution Manometry"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8924-8656","authenticated-orcid":false,"given":"Kaori","family":"Nishikubo\u2010Tanaka","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rie","family":"Asayama","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazutaka","family":"Kochi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9057-0784","authenticated-orcid":false,"given":"Masahiro","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiko","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3458-3190","authenticated-orcid":false,"given":"Hiroyuki","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naohito","family":"Hato","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2016.08.004"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001756-199806010-00022"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(19)36057-3"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)91105-d"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(93)90847-6"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajplegacy.1899.2.3.266"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.2001.81.2.929"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00236530"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1993.00540060049016"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02424928"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00075197-200405000-00008"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00009554"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813489506"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02407397"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02493487"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200003000-00021"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1044\/2019_PERS-SIG13-2018-0027"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2013015\u20139643\u20130"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.1989.257.5.G748"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm16028"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2018.00286"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-150687"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/1055665619877053"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-017-9811-5"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599810390885"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2019.06.001"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2016.07.013"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(77)80030-9"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2010.04.029"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0039-6109(16)39430-0"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.11.049"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1993.00540060049016"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.41.2_part_1.244"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00874113"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1161\/hs0901.094278"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajplegacy.1951.166.1.142"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.81"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24311"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31817dfd02"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21150"},{"key":"e_1_2_7_42_1","first-page":"1","article-title":"Anatomy and physiology of velopharyngeal closure and insufficiency","volume":"76","author":"Raol N","year":"2015","journal-title":"Adv Otorhinolaryngol"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2015.10.084"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.5535\/arm.2017.41.5.776"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm14021"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01354550"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-011-9385-6"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.5535\/arm.2015.39.3.425"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4614-3779-6_8"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31155","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T10:49:23Z","timestamp":1721818163000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.31155"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,2]]},"references-count":48,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1002\/lary.31155"],"URL":"https:\/\/doi.org\/10.1002\/lary.31155","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"type":"print","value":"0023-852X"},{"type":"electronic","value":"1531-4995"}],"subject":[],"published":{"date-parts":[[2023,11,2]]},"assertion":[{"value":"2023-05-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}