Aim:This study aimed to demonstrate the feasibility of a novel high-resolution manometry (HRM) system, and to establish normal values of swallowing pressures along the velopharynx and upper esophagus. Methods:Thirty three asymptomatic adult Japanese controls were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1 cm apart was positioned to record pressures during swallowing from the velopharynx to the upper esophagus. The maximum values of the swallowing (dry and 5 ml of water) pressures at velo, mesohypopharynx, and at the upper esophageal sphincter (UES) were measured. The resting UES pressure, the length of the part in the cervical esophagus showing the resting UES pressure, and the distances from the nostril to the above-mentioned points of pressure measurement were also measured. Results:The maximum value of dry and water swallowing pressures at the velopharynx, meso-hypopharynx and UES, and the distances from the nasal vestibulum to each point in male were 141.1±73.5 (mmHg, mean ± standard deviation) and 162.7±94.9, 175.3±59.7 and 182.9±83.6, 172.7±73.8 and 236.1±78.9, and 10.0±1. Conclusion:The present study provides anatomical and physiological information about normal swallowing along the velopharynx and upper esophagus, which will be an aid to the future clinical and investigative studies.

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Aim: This study aimed to investigate the effects of tongue-holding maneuver (THM) during swallowing using a novel high-resolution manometry (HRM) system. Materials and Methods: Thirty three asymptomatic Japanese adults were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1 cm apart was positioned to record pressures from the velopharynx to the upper esophagus at rest and during swallowing. The maximum values of the dry swallowing pressures at velopharynx, meso-hypopharynx, upper esophageal sphincter (UES), and distance from the nostril to each point of maximum values with and without THM were measured.Results: The maximum pressure was significantly greater when swallowing with THM than without THM only at UES (p= 0.0478), while there was no difference in the pressures between swallowing with or without THM at any other site. The distance from the nostril to the UES was significantly shorter (p= 0.0132) when swallowing with THM than without THM, while there was again no significant difference between swallowing with or without THM at any other site.Conclusion: These findings indicate that THM is likely to have a potential to facilitate compensatory swallowing power of the upper esophageal sphincter. Results: The maximum pressure was significantly greater when swallowing with THM than without THM only at UES (p= 0.0478), while there was no difference in the pressures between swallowing with or without THM at any other site. The distance from the nostril to the UES was significantly shorter (p= 0.0132) when swallowing with THM than without THM, while there was again no significant difference between swallowing with or without THM at any other site.Conclusion: These findings indicate that THM is likely to have a potential to facilitate compensatory swallowing power of the upper esophageal sphincter.

The present study provided us with physiological information regarding normal UES pressure in relation to head rotation. This data will be of aid to future clinical and investigative swallowing studies. Additionally, the current study provides evidence of the safety and usefulness of the head rotation maneuver for dysphagic patients.

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