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The unrealised potential of videofluoromanometry (VFM) in dysphagia work-up. Objective: To compare the actual and potential use of Videofluoromanometry (VFM) in dysphagia work-up.
Methodology: Qualitative paper based on (1) a review of literature in English and (2) experience-based opinion.
Results: The history, rationale and technical aspects of VFM are described. VFM indications are reviewed. The present clinical use of VFM is compared to the clinical potential originally foreseen.
Discussion: Several suggestions for achieving the unrealised potential of VFM are proposed based on personal experience with VFM.
Conclusion: Later studies should focus on relative pressure values rather than absolute values. A relative physiological variable is proposed: the Pharyngo-Oesophageal Pressure Gradient (POPG). A family of diseases with specific “manometric signatures” should be determined and a POPG reading scale should be established accordingly. Once that has been done, subsequent studies should determine the best technical approach to recording the POPG. Eventually, POPG results should be compared to Modified Barium Swallow results in order to specify potential disease-specific VFM patterns.