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.

Objective: To obtain clues on the anatomical features of the eustachian tube (ET) related to the susceptibility to otitis media with effusion (OME) in children. Methods:The angle and length of the ET in children with (54 ears, OME children) and without OME (50 ears, normal children), as well as those of normal adults were measured on the CT using the multiplanar reconstruction technique Results:The angles of ET in OME children group, normal children group, and normal adult group were 20.4±3.5 degree (°) and 21.2±4.8°, 19.9±3.4°and 20.0±3.6°, and 27.3±2.7° and 27.3±2.8° in the right and left sides, respectively. There was no significant difference between the right and left sides in any group (p=0.541, p=0.952, p=0.978). The lengths of the ET in the OME children group, normal children group, and normal adult group were 37.2±3.0 mm (mean±standard deviation) and 37.6±3.2 mm, 37.5±3.3 mm and 38.0±3.2 mm, and 42.5±2.8 mm and 42.9±2.9 mm in the right and the left side, respectively. There was no significant difference between in the right and left sides in any groups (p=0.670, p=0.597, and p=0.545).Both the angles and lengths were significantly greater in the normal adult group than in either the OME children group or normal children group (one-way ANOVA and Fisher's PLSD tests, p<0.05), but there was no significant difference either in the angle or length of the ET between the OME group and normal children group (p>0.05). In the OME and normal children groups, the angle was observed to constantly increase with age, and the values were found to be within the range of the adult size in all the cases older than 2737 days and 2818 days in the OME children group and in normal children group, respectively. In addition to the angle, the lengths were observed to constantly increase with age, but the increase appeared to be greater in younger age until around 1000 to 1500 days (3 to 4 year old) than in the older age, and the values were found to be within the range of the adult size in all the cases older than 2470 days and 2818 days in OME children group and in normal children group, respectively. Conclusion:The angle and length of ET are more horizontal and shorter in infants than in adults. However, there is no statistical difference between the angle and length of ET in infants with and without OME. These results suggest that short and horizontal ET may be one of the predisposing factors related to the high susceptibility of OME in infants and children rather than etiological factors.

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.

OBJECTIVE: To clarify the three-dimensional anatomical features of the sphenoid sinus and its surrounding structures as are relevant to performing an endoscopic sphenoidotomy. METHODS: Various dimensions of 224 CT images of the sphenoid sinus and surrounding structures from 122 Japanese adult patients were measured using the multiplanar reconstruction technique. RESULTS: The mean distance from the nasal sill to the sphenoid ostium was nearly 66 mm, and that from the sphenoid ostium to the posterior wall of the sphenoid sinus was nearly 14 mm. The angles from the sphenoid ostium to both the carotid artery and the optic canal varied among the patients. The sphenoid ostium was located at almost the vertical midpoint of the anterior wall of the sphenoid sinus. CONCLUSION: The present study provides anatomical information about the sphenoid sinus and surrounding structures that is essential for avoiding complications in performing an endoscopic sphenoidotomy.

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