Correlation Between “Jet Phenomenon” and Pharyngeal High Resolution Manometry: A Pilot Study

ABSTRACT Objectives Jet phenomenon (JP) refers to a turbulent high‐flow jet of contrast agent passing through a narrow upper esophageal sphincter (UES) and is observed on fluoroscopic swallow studies in some patients with cricopharyngeal muscle dysfunction (CPMD). Pharyngeal high‐resolution manometry (Ph‐HRM) is a useful adjunct in assessing patients with CPMD and diagnosing UES dysfunction based on parameters highlighted in the international Leuven consensus. We propose a novel scoring system for JP and report on the Ph‐HRM findings in a cohort of CPMD patients with and without JP. Methods Consecutive patients with CPMD who underwent Ph‐HRM were included in the study. Patients who received prior treatments were excluded. Patients were scored 1–4 based on fluoroscopic features of JP and divided into two groups according to the absence (jet score 1–2) or presence (jet score 3–4) of sustained JP. Ph‐HRM findings were compared between the groups. Results Overall, 7 patients with and 13 without JP were included. Both integrated relaxation pressures (IRP) and intra‐bolus pressures (IBP) were significantly higher in the JP (+) group, 14.06 versus 3.92 ( p : 0.0040) and 25.57 versus 4.72 ( p : 0.0065), respectively. Pharyngeal, mesopharyngeal, and hypopharyngeal contractile integrals (PhCI, MCI, and HCI) were also significantly higher in the JP (+) group. IRP, PhCI, MCI, and HCI were significantly positively correlated with the severity of jet score. Conclusions The presence of sustained JP (jet score 3–4) in patients with CPMD significantly correlates with higher contractile integrals at multiple pharyngeal anatomical subsites and UES dysfunction features on Ph‐HRM. Level of Evidence 4.