Figure 3 - Manometric example of upper esophageal sphincter dysfunction.

Manometric tracing is from a patient with cervical dysphagia for solids and cough. Upper esophageal sphincter (UES) basal pressure is being recorded with a sleeve device. During the dry swallow, the UES is seen to fail to relax and, in fact, starts to contract slightly before the arrival of the pharyngeal pressure wave at that level. The subsequent low pressure seen after passage of the peristaltic wave is an artifact related to emptying of the sleeve by the contraction, with subsequent slow refilling. Note that the tracing below the sleeve, located in the distal part of the UES, shows a spurious relaxation. This is the result of the temporary displacement of the UES above this point sensor (the UES remains over the sleeve). The 5 mL water swallow shows a slight relaxation, but this is incomplete and of short duration.