Effects of Head Rotation and Head Tilt on Pharyngeal Pressure Events Using High Resolution Manometry

Kim, Cheol Ki; Ryu, Ju Seok; Song, Sun Hong; Koo, Jung Hoi; Lee, Kyung Duck; Park, Hee Sun; Oh, Yoongul; Min, Kyunghoon

doi:10.5535/arm.2015.39.3.425

Cited by 22 publications

(5 citation statements)

References 16 publications

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“…In the hypotonic UES group, the median of HADS score were for HADS-T 13 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19), HADS-A 7(5-10) and HADS-D 6(3-8). In the normotonic UES group: for HADS-T 13(9-19), HADS-A 8(5-11) and HADS-D 6(3.75-8).…”

Section: Results Resultsmentioning

confidence: 99%

Psychiatric Symptoms and the Upper Esophageal Sphincter

Dias¹,

Laurino²,

Fernando³

et al. 2020

SGO

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Introduction: There is a significant association between psychiatric diseases and esophageal disorders. The upper esophageal sphincter (UES) function may be affected by psychiatric diseases. This study aims to evaluate the correlation between psychiatric symptoms (anxiety and depression) and UES pressure. Methods: We retrospectively reviewed data from 200 adult patients (median age 41 (34-53) years; 47% males). All patients underwent high-resolution esophageal manometry and ambulatory pH monitoring. UES basal pressure (UESP) was measured at the beginning of the test at the point of maximum pressure as an average of a period of 20 seconds after a period of adaptation. Hospital Anxiety and Depression Scale (HADS) was used to evaluate the presence of anxiety and depressive symptoms. Results: Median UESP was 80 (56-108) mmHg. There were 53 (26%) hypotonic (51% female, median age 43 (34-51) years), 100 (50%) normotonic (53% female, median age 42 (35-53) years) and 47 (23%) hypertonic (53% female, median age 38 (32-52) years) UES. There was no difference in HADS scores among groups. There was no correlation between UESP and HADS scores Conclusion: UESP does not correlate with minor psychiatric disorders.

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Section: Results Resultsmentioning

confidence: 99%

Psychiatric Symptoms and the Upper Esophageal Sphincter

Dias¹,

Laurino²,

Fernando³

et al. 2020

SGO

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“…In HRM studies, parameters related to UES opening, such as UES relaxation time 44–46 and minimum UES pressure, 44,45 have often been reported. The minimum UES pressure in healthy individuals was around 0 mmHg 43,47 and significantly increased in patients with dysphagia 43 . Massey reported that UES relaxation time is more sensitive and reliable in identifying UES dysfunction than UES pressure because UES pressure was sensitive to emotional stress, speech, and neck movements 48 .…”

Section: Discussionmentioning

confidence: 99%

Oral Intake Difficulty and Aspiration Pneumonia Assessment Using High‐Resolution Manometry

Nishikubo‐Tanaka,

Asayama,

Kochi

et al. 2023

The Laryngoscope

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ObjectiveThe sequential generation of swallowing pressure (SP) from the nasopharynx to the proximal esophagus is important for the bolus to pass from the oral cavity to the esophagus. The purpose of this study was to investigate the correlation of the SP sequence mode on high‐resolution manometry (HRM) with oral intake difficulty and aspiration pneumonia.MethodsConsecutive patients with dysphagia who were admitted to our dysphagia clinic between November 2016 and November 2020 were enrolled in this cross‐sectional study. We classified the HRM pressure topography data according to the SP sequence mode into type A, normal; B, partially decreased; C, totally decreased; and D, sequence disappeared, and according to the upper esophageal sphincter (UES) during pharyngeal swallowing into type 1, flattening and 2, non‐flattening. Clinical dysphagia severity was determined based on oral intake difficulty and aspiration pneumonia.ResultsIn total, 202 patients with dysphagia (mean [standard deviation] age, 68.3 [14.5] years; 140 [69.8%] male) were enrolled. Type C (odds ratio [OR], 10.48; 95% confidence interval [CI], 2.89–51.45), type D (OR, 19.90; 95% CI, 4.18–122.35), and type 2 (OR, 6.36; 95% CI, 2.88–14.57) were significantly related to oral intake difficulty. Type C (OR, 3.23; 95% CI, 1.08–11.12) and type 2 (OR, 4.18; 95% CI, 1.95–9.15) were significantly associated with aspiration pneumonia.ConclusionThe failure of sequential generation of SP was associated with higher risk of oral intake difficulty and aspiration pneumonia. These assessments are useful in understanding the pathophysiology and severity of dysphagia and in selecting safety nutritional management methods.Level of Evidence4 Laryngoscope, 2023

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“…The channels of interest were velopharynx (VP), tongue base (TB), epiglottis, pharyngeal constrictors, and preand post-swallow upper esophageal sphincter (UES). These channels were defined manometrically in accordance with previous reports [7,[14][15][16]. Variables included maximal pressure and area integral in regions of VP and TB.…”

Section: Methodsmentioning

confidence: 99%

Effects of Chin-Down Maneuver on Pharyngeal Pressure Generation According to Dysphagia and Viscosity

Lee

Kim

et al. 2020

Ann Rehabil Med

Self Cite

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Objective To demonstrate the effects of chin-down maneuver on swallowing by using high-resolution manometry (HRM).Methods HRM data of 20 healthy subjects and 64 dysphagic patients were analyzed. Participants swallowed 5 mL of thin and honey-like liquids in neutral and chin-down positions. HRM was used to evaluate maximal velopharyngeal pressure/area, maximal tongue base pressure/area, maximal pharyngeal constrictor pressure, pre-/post-swallow upper esophageal sphincter (UES) peak pressure, minimal UES pressure, UES activity time, and nadir duration.Results Compared to the neutral position, the chin-down maneuver significantly increased tongue base pressure in both normal and dysphagic groups as well as for both honey-like and thin viscosities, although the honey-like liquid did not reach statistical significance in the dysphagic group. Regarding pharyngeal constrictors and pre-swallow peak UES pressure, the healthy group showed a significant decrease in thin liquid swallowing and decreasing tendency in honeylike liquid swallowing. UES nadir duration was significantly decreased for honey-like liquid swallowing in the dysphagic group and for both thin and honey-like liquids in the healthy group. UES nadir duration of honey-like and thin flow swallowing in the dysphagia group was 0.26 seconds after the chin-down maneuver, which was severely limited.Conclusion This study showed a different kinetic effect of the chin-down maneuver between the healthy and dysphagic groups, as well as between thin and honey-like viscosities. The chin-down maneuver increased tongue base pressure and decreased UES nadir duration, which the latter was severely limited in dysphagic patients. Therefore, appropriate application of the chin-down maneuver in clinical practice is required.

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Effects of Head Rotation and Head Tilt on Pharyngeal Pressure Events Using High Resolution Manometry

Cited by 22 publications

References 16 publications

Psychiatric Symptoms and the Upper Esophageal Sphincter

Psychiatric Symptoms and the Upper Esophageal Sphincter

Oral Intake Difficulty and Aspiration Pneumonia Assessment Using High‐Resolution Manometry

Effects of Chin-Down Maneuver on Pharyngeal Pressure Generation According to Dysphagia and Viscosity

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