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Sleeve sensors



Sleeve sensors

Background

  • The sleeve is a unique position-tolerant sensor which is the only reliable way of making continuous recordings of sphincter pressure, apart from an extensive chain of very closely spaced sideholes

  • Reliable measurement of lower oesophageal sphincter relaxation is an especially important clinical application of the sleeve.

  • Water perfusion is essential for functioning of the sleeve.

  • Dentsleeve Technical Note 2, Version 2, gives more detailed information on sleeve functioning.
    Sleeve length

    The normal range of sphincter movement should be within the length of the sleeve to ensure that sphincter pressure is recorded continuously.

    The range of sphincter movement varies according to body size and sphincter type.

    Recommended sleeve lengths given below are only indicative; the best sleeve length depends on the application, and in some cases, the mode of intubation.
    Dentsleeve can advise.

    Sleeve length is best kept to the minimum consistent with maintenance of contact with the sphincter, as recordings from excessively long sleeves will be more influenced by motor events above and below the sphincter.

    Excessively long sleeves also have very low rates of pressure rise at their distal end (see page 65).
    Sleeve width

    The width of the cross section of the sleeve sensor is varied in approximate proportion to the diameter of the extrusion on which it is built.

    Variation of sleeve sensor width ensures that the sleeve does not add excessive bulk to the cross section of the extrusion on which it is built. The sleeve sensor width is chosen to match the perfusion rate required for adequate sleeve performance to the appropriate perfusion rate for side hole channels incorporated into a particular manometric assembly.
             
             
             
             
             
    Sleeve cross section

    All sleeve assembly cross sections other than upper oesophageal sphincter sleeves are designed to be as close to circular as possible.

    Upper oesophageal sphincter sleeves are made to be close to oval, so that the sleeve self orientates in the anterior-posterior position within the sphincter.

    Sleeve water perfusion rates

    Sleeves sense sphincter pressure optimally within a relatively narrow range of perfusion rates.

    The optimal perfusion rate is defined by the width and length of the sleeve sensor.

     

    If a sleeve is perfused at a rate more than double that recommended, this will lead to an undermeasurement at the proximal end of the sleeve of 2-3 mmHg.

    If a sleeve is perfused at a rate slower than that recommended, the rate of pressure rise achieved by the sleeve may be too low for reliable recording.

    The sleeve design is matched to the diameter of the manometric channels of the extrusion on which the sleeve is built.

    For a particular sphincter and extrusion, the recommended rate of perfusion will give pressure rise rates that are adequate for recordings of both sphincter pressure and peristaltic pressures in the adjacent non-sphincter regions (see table below).

    Dentsleeve Technical Note 2 Version 2 gives more detailed explanation on sleeve perfusion and pressure rise rates.

       
             
             
             
             

    References and further information

    Please see Dentsleeve Technical Note 2 Version 2 which gives detailed information on different types of sleeve sensor, and key original scientific papers that describe these, and their use.

       
             
             
             

    Dentsleeve International Ltd

     

    Specialised components of manometric assemblies